Healthcare Provider Details

I. General information

NPI: 1841153475
Provider Name (Legal Business Name): ARMS WIDE OPEN NM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARQUETTE AVE NW STE 1200
ALBUQUERQUE NM
87102-5312
US

IV. Provider business mailing address

1553 BROADWAY
HEWLETT NY
11557-1427
US

V. Phone/Fax

Practice location:
  • Phone: 505-404-0058
  • Fax: 347-222-3895
Mailing address:
  • Phone: 505-404-0058
  • Fax: 347-222-3895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: EFRAIM COOPER
Title or Position: COO
Credential:
Phone: 845-521-5407