Healthcare Provider Details
I. General information
NPI: 1407771314
Provider Name (Legal Business Name): OPEN ARMS NOVARA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6671 PRINCETON PARK TRL
LITHONIA GA
30058-7029
US
IV. Provider business mailing address
3343 PEACHTREE RD NE STE 145
ATLANTA GA
30326-1427
US
V. Phone/Fax
- Phone: 943-255-0028
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARQUITA
BRISCO
Title or Position: OWNER
Credential:
Phone: 943-255-0028