Provider Demographics
NPI:1083914717
Name:OPEN ARMS CHRISTIAN MINISTRIES
Entity Type:Organization
Organization Name:OPEN ARMS CHRISTIAN MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COREY
Authorized Official - Suffix:
Authorized Official - Credentials:MAMFT
Authorized Official - Phone:812-659-2533
Mailing Address - Street 1:4516 W STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:47424-5207
Mailing Address - Country:US
Mailing Address - Phone:812-659-2533
Mailing Address - Fax:812-659-2477
Practice Address - Street 1:4516 W STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:IN
Practice Address - Zip Code:47424-5207
Practice Address - Country:US
Practice Address - Phone:812-659-2533
Practice Address - Fax:812-659-2477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN155516933 43620322D00000X
347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN033Medicaid
IN03Medicaid
IN21Medicaid
IN26Medicaid