Provider Demographics
NPI:1376182584
Name:OPEN ARMS ADULT CARE WEST1
Entity Type:Organization
Organization Name:OPEN ARMS ADULT CARE WEST1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SPARKLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-452-5637
Mailing Address - Street 1:16235 DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-7303
Mailing Address - Country:US
Mailing Address - Phone:440-452-5637
Mailing Address - Fax:440-306-9017
Practice Address - Street 1:2428 ELYRIA AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-1366
Practice Address - Country:US
Practice Address - Phone:440-452-5637
Practice Address - Fax:440-452-5637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & FamilyGroup - Single Specialty