Provider Demographics
NPI:1295032043
Name:OPEN ARMS GROUP HOME
Entity Type:Organization
Organization Name:OPEN ARMS GROUP HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARVA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:817-296-0782
Mailing Address - Street 1:2833 MEADE DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-8344
Mailing Address - Country:US
Mailing Address - Phone:817-296-0782
Mailing Address - Fax:817-531-6101
Practice Address - Street 1:2401 SHROPSHIRE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76105-5239
Practice Address - Country:US
Practice Address - Phone:817-296-0782
Practice Address - Fax:817-531-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities