Provider Demographics
NPI:1134374622
Name:EMPTY ARMS OUTREACH MINISTRY, INC.
Entity type:Organization
Organization Name:EMPTY ARMS OUTREACH MINISTRY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:M
Authorized Official - Last Name:COMBS-MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:LRP, SW, BA
Authorized Official - Phone:804-862-4036
Mailing Address - Street 1:4725 WOODSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-8801
Mailing Address - Country:US
Mailing Address - Phone:804-862-4036
Mailing Address - Fax:804-861-1239
Practice Address - Street 1:4526 BRICKWOOD MEADOW CT
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-8866
Practice Address - Country:US
Practice Address - Phone:804-861-0596
Practice Address - Fax:804-861-1239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VASS14106, SS164/32608320900000X
VASS164/326-08, SS1410320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities