Provider Demographics
NPI:1417355017
Name:BLESSED OPEN ARMS
Entity Type:Organization
Organization Name:BLESSED OPEN ARMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AGENCY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GERMAINE
Authorized Official - Middle Name:VIOLA
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-551-4147
Mailing Address - Street 1:1500 BRAGG BLVD.
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-4289
Mailing Address - Country:US
Mailing Address - Phone:910-551-4147
Mailing Address - Fax:
Practice Address - Street 1:1500 BRAGG BLVD.
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4289
Practice Address - Country:US
Practice Address - Phone:910-551-4147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health