Provider Demographics
NPI:1710573357
Name:OPEN ARMS ASSISTED LIVING
Entity Type:Organization
Organization Name:OPEN ARMS ASSISTED LIVING
Other - Org Name:OPEN ARMS ASSISTED LIVING SUITE A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HYNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-452-8006
Mailing Address - Street 1:12150 ANDREWS DR
Mailing Address - Street 2:STE AANDB
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-4441
Mailing Address - Country:US
Mailing Address - Phone:720-452-8006
Mailing Address - Fax:
Practice Address - Street 1:12150 ANDREWS DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-4441
Practice Address - Country:US
Practice Address - Phone:720-452-8006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1710573357Medicaid