Healthcare Provider Details

I. General information

NPI: 1962846667
Provider Name (Legal Business Name): OPEN ARMS HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 CENTERVILLE RD # L-5
TALLAHASSEE FL
32308-4317
US

IV. Provider business mailing address

2365 CENTERVILLE RD # L-5
TALLAHASSEE FL
32308-4317
US

V. Phone/Fax

Practice location:
  • Phone: 850-273-8833
  • Fax:
Mailing address:
  • Phone: 850-273-8833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number233047
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number233047
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE ANGELINA WHITE
Title or Position: OWNER
Credential:
Phone: 850-273-8833