Healthcare Provider Details

I. General information

NPI: 1912373150
Provider Name (Legal Business Name): OPEN ARMS COMMUNITY SERVICE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2015
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5120 WHITFIELD CHAPEL RD
LANHAM MD
20706-1902
US

IV. Provider business mailing address

8006 OAT RIDGE CT
BOWIE MD
20715-4620
US

V. Phone/Fax

Practice location:
  • Phone: 301-577-4882
  • Fax:
Mailing address:
  • Phone: 301-577-4882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC4285
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number11890
License Number StateMD

VIII. Authorized Official

Name: MR. CHARLES E. CATO SR.
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 301-577-4880