Provider Demographics
NPI:1659508620
Name:OPEN ARMS
Entity type:Organization
Organization Name:OPEN ARMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SURRATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-830-3770
Mailing Address - Street 1:105 W 4TH ST
Mailing Address - Street 2:STE 500
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-3823
Mailing Address - Country:US
Mailing Address - Phone:336-830-3770
Mailing Address - Fax:
Practice Address - Street 1:105 W 4TH ST
Practice Address - Street 2:STE 500
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-3823
Practice Address - Country:US
Practice Address - Phone:336-830-3770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health