MEDICARE: OPEN ARMS HOME, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1982362240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN ARMS HOME, LLC

Provider Business Mailing Address
First Line	:	23 JORDANA DR
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-4406
Country	:	US
Telephone Number	:	614-598-6215
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 HAMILTON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2059
Country	:	US
Telephone Number	:	614-598-6215
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	FARDOSA ODOWA
Credential	:	NURSE
Telephone Number	:	614-598-6215

Provider Enumeration Date	:	12/03/2021
Last Update Date	:	12/03/2021

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Directions to “OPEN ARMS HOME, LLC ” Practice Location

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