Healthcare Provider Details

I. General information

NPI: 1316863962
Provider Name (Legal Business Name): OPEN ARMS RESPONSE ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 N 75TH AVE APT 1083
GLENDALE AZ
85303-2518
US

IV. Provider business mailing address

7111 N 75TH AVE APT 1083
GLENDALE AZ
85303-2518
US

V. Phone/Fax

Practice location:
  • Phone: 602-907-7855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MR. TAGBE TOE DANIEL GOE
Title or Position: CEO
Credential:
Phone: 602-907-7855