Healthcare Provider Details

I. General information

NPI: 1053128280
Provider Name (Legal Business Name): OPEN ARMS HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 PEACHTREE INDUSTRIAL BLVD STE 135
SUWANEE GA
30024-6737
US

IV. Provider business mailing address

1000 PEACHTREE INDUSTRIAL BLVD STE 135
SUWANEE GA
30024-6737
US

V. Phone/Fax

Practice location:
  • Phone: 408-569-2525
  • Fax:
Mailing address:
  • Phone: 408-569-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. YVES R CHERY
Title or Position: OWNER
Credential: NP
Phone: 408-569-2525