Provider Demographics
NPI:1275070591
Name:OPEN ARMS BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:OPEN ARMS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LASHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-381-8946
Mailing Address - Street 1:4916 CINNAMON SPICE CT
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-2587
Mailing Address - Country:US
Mailing Address - Phone:626-381-8946
Mailing Address - Fax:
Practice Address - Street 1:4916 CINNAMON SPICE CT
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-2587
Practice Address - Country:US
Practice Address - Phone:626-381-8946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0802001482251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health