Provider Demographics
NPI:1528596947
Name:WITH OPEN ARMS PRIVATE HOME CARE
Entity Type:Organization
Organization Name:WITH OPEN ARMS PRIVATE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-575-1865
Mailing Address - Street 1:3025 UNIVERSITY AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-2101
Mailing Address - Country:US
Mailing Address - Phone:706-641-2297
Mailing Address - Fax:706-641-2298
Practice Address - Street 1:3025 UNIVERSITY AVE STE 203
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-2101
Practice Address - Country:US
Practice Address - Phone:706-641-2297
Practice Address - Fax:706-641-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA106R1127251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003181545AMedicaid