Provider Demographics
NPI:1609405331
Name:OPEN ARMS & HEARTS HEALTH SERVICES
Entity Type:Organization
Organization Name:OPEN ARMS & HEARTS HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROYER
Authorized Official - Suffix:
Authorized Official - Credentials:CAC-AD
Authorized Official - Phone:443-437-7128
Mailing Address - Street 1:1532 OCEAN HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:POCOMOKE CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21851-3023
Mailing Address - Country:US
Mailing Address - Phone:443-437-7128
Mailing Address - Fax:443-437-7131
Practice Address - Street 1:1532 OCEAN HWY STE 102
Practice Address - Street 2:
Practice Address - City:POCOMOKE CITY
Practice Address - State:MD
Practice Address - Zip Code:21851-3023
Practice Address - Country:US
Practice Address - Phone:443-437-7128
Practice Address - Fax:443-437-7131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-04
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1538700372Medicaid
MD1992355465Medicaid