Provider Demographics
NPI:1982362240
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:NURSE
Authorized Official - Phone:614-598-6215
Mailing Address - Street 1:23 JORDANA DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4406
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?:Yes
Parent Organization LBN:OPEN ARMS HOME, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home