Provider Demographics
NPI:1407197213
Name:OPEN ARMS, LLC
Entity Type:Organization
Organization Name:OPEN ARMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:DION
Authorized Official - Last Name:HANKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-943-0092
Mailing Address - Street 1:9034 N 23RD AVE
Mailing Address - Street 2:SUITE 13
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-2849
Mailing Address - Country:US
Mailing Address - Phone:602-943-0092
Mailing Address - Fax:602-943-4038
Practice Address - Street 1:9034 N 23RD AVE
Practice Address - Street 2:SUITE 13
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2849
Practice Address - Country:US
Practice Address - Phone:602-943-0092
Practice Address - Fax:602-943-4038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health