Provider Demographics
NPI:1093560724
Name:ORLANDO LUTHERAN TOWERS INC
Entity Type:Organization
Organization Name:ORLANDO LUTHERAN TOWERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:SHANNON
Authorized Official - Last Name:GERRITY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-515-3810
Mailing Address - Street 1:300 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3544
Mailing Address - Country:US
Mailing Address - Phone:407-425-1033
Mailing Address - Fax:
Practice Address - Street 1:404 MARIPOSA ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-6634
Practice Address - Country:US
Practice Address - Phone:407-515-3888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORLANDO LUTHERAN TOWERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility