Provider Demographics
NPI:1992374946
Name:OPEN ARMS HOME, LLC
Entity Type:Organization
Organization Name:OPEN ARMS HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FARDOSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODOWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-598-6215
Mailing Address - Street 1:2323 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2059
Mailing Address - Country:US
Mailing Address - Phone:614-598-6215
Mailing Address - Fax:
Practice Address - Street 1:2323 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2059
Practice Address - Country:US
Practice Address - Phone:614-598-6215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home