Provider Demographics
NPI:1356657118
Name:OPEN ARMS ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:OPEN ARMS ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TISHIKA
Authorized Official - Middle Name:VANETT
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:662-588-7292
Mailing Address - Street 1:118 FRONT AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-2461
Mailing Address - Country:US
Mailing Address - Phone:662-887-3331
Mailing Address - Fax:662-887-3332
Practice Address - Street 1:118 FRONT AVE
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2461
Practice Address - Country:US
Practice Address - Phone:662-887-3331
Practice Address - Fax:662-887-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based