Provider Demographics
NPI:1407621345
Name:OPEN ARMS SENIOR LIVING
Entity Type:Organization
Organization Name:OPEN ARMS SENIOR LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORDANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAICH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LALD
Authorized Official - Phone:218-576-5664
Mailing Address - Street 1:4414 MARTIN RD
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55803-1268
Mailing Address - Country:US
Mailing Address - Phone:218-275-7280
Mailing Address - Fax:218-275-7276
Practice Address - Street 1:4414 MARTIN RD
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:MN
Practice Address - Zip Code:55803-1268
Practice Address - Country:US
Practice Address - Phone:218-275-7280
Practice Address - Fax:218-275-7276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances