| Entity Name: | OPEN ARMS MED WAIVER PROVIDER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Jul 2001 (24 years ago) |
| Document Number: | P01000073764 |
| FEI/EIN Number | 593708422 |
| Address: | 37640 QUAIL RIDGE CIR, LEESBURG, FL, 34788 |
| Mail Address: | 37640 QUAIL RIDGE CIR, LEESBURG, FL, 34788, US |
| ZIP code: | 34788 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871799890 | 2007-06-26 | 2008-05-15 | PO BOX 595, TAVARES, FL, 327780595, US | 37640 QUAIL RIDGE CIR, LEESBURG, FL, 347888117, US | |||||||||||||||||||||||||||
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| Phone | +1 352-551-3263 |
| Fax | 3525894442 |
Authorized person
| Name | MR. ANTONY M SCHLISSIO |
| Role | CO-OWNER |
| Phone | 3525513263 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 677896896 |
| State | FL |
| Issuer | MEDICAID |
| Number | 677896898 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SCHLISSIO ANTONY | Agent | 37640 QUAIL RIDGE CIRCLE, LEESBURG, FL, 34788 |
| Name | Role | Address |
|---|---|---|
| SCHLISSIO ANTONY | Director | 37640 QUAIL RIDGE CIRCLE, LEESBURG, FL, 34788 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-02-17 | 37640 QUAIL RIDGE CIR, LEESBURG, FL 34788 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-19 | 37640 QUAIL RIDGE CIRCLE, LEESBURG, FL 34788 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-04-23 | 37640 QUAIL RIDGE CIR, LEESBURG, FL 34788 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-04-23 | SCHLISSIO, ANTONY | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-02-17 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-04-29 |
| ANNUAL REPORT | 2019-04-18 |
| ANNUAL REPORT | 2018-04-05 |
| ANNUAL REPORT | 2017-04-20 |
| ANNUAL REPORT | 2016-04-19 |
| ANNUAL REPORT | 2015-04-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
