Provider Demographics
NPI:1912373150
Name:OPEN ARMS COMMUNITY SERVICE CENTER
Entity Type:Organization
Organization Name:OPEN ARMS COMMUNITY SERVICE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:CATO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:301-577-4880
Mailing Address - Street 1:8006 OAT RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4620
Mailing Address - Country:US
Mailing Address - Phone:301-577-4882
Mailing Address - Fax:
Practice Address - Street 1:5120 WHITFIELD CHAPEL RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1902
Practice Address - Country:US
Practice Address - Phone:301-577-4882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4285101YP2500X
MD118901041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty