Provider Demographics
NPI:1720201189
Name:OPEN ARMS HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:OPEN ARMS HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIZHOV
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-645-5450
Mailing Address - Street 1:301 N. PRAIRIE AVE.
Mailing Address - Street 2:SUITE 320
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4507
Mailing Address - Country:US
Mailing Address - Phone:310-645-5450
Mailing Address - Fax:310-645-5460
Practice Address - Street 1:301 N. PRAIRIE AVE.
Practice Address - Street 2:SUITE #320
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4507
Practice Address - Country:US
Practice Address - Phone:310-645-5450
Practice Address - Fax:310-645-5460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000414251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059265Medicare Oscar/Certification