Healthcare Provider Details

I. General information

NPI: 1790647824
Provider Name (Legal Business Name): OPEN ARMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3704 S CARAWAY RD STE 5
JONESBORO AR
72404-0754
US

IV. Provider business mailing address

3704 S CARAWAY RD STE 5
JONESBORO AR
72404-0754
US

V. Phone/Fax

Practice location:
  • Phone: 87-091-9563
  • Fax:
Mailing address:
  • Phone: 87-091-9563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC0050X
TaxonomyCritical Access Hospital Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ERICA WALTER
Title or Position: LICENSED PROFESSIONAL COUNSELOR (LP
Credential:
Phone: 870-707-1467