Provider Demographics
NPI:1669156717
Name:OPEN ARMS CARE INCORPORATION
Entity type:Organization
Organization Name:OPEN ARMS CARE INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANE
Authorized Official - Middle Name:KASSIM
Authorized Official - Last Name:EJERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-332-4219
Mailing Address - Street 1:894 JUNO AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3714
Mailing Address - Country:US
Mailing Address - Phone:651-332-4219
Mailing Address - Fax:
Practice Address - Street 1:894 JUNO AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3714
Practice Address - Country:US
Practice Address - Phone:651-332-4219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health