Healthcare Provider Details

I. General information

NPI: 1801755814
Provider Name (Legal Business Name): ARMS WIDE OPEN AZ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W UNIVERSITY AVE
FLAGSTAFF AZ
86001-2851
US

IV. Provider business mailing address

1553 BROADWAY
HEWLETT NY
11557-1427
US

V. Phone/Fax

Practice location:
  • Phone: 833-898-9222
  • Fax: 347-222-3895
Mailing address:
  • Phone: 833-898-9222
  • Fax: 347-222-3895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EFRAIM COOPER
Title or Position: COO
Credential:
Phone: 845-521-5407