Healthcare Provider Details

I. General information

NPI: 1689261117
Provider Name (Legal Business Name): OPEN ARMS CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 12/30/2020
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 ROWLAND AVE NE
CANTON OH
44705-1058
US

IV. Provider business mailing address

2516 3RD ST NE
CANTON OH
44704-2302
US

V. Phone/Fax

Practice location:
  • Phone: 419-932-1446
  • Fax:
Mailing address:
  • Phone: 419-932-1446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KELLY S SIMS
Title or Position: OWNER/CEO
Credential: MPA
Phone: 419-932-1446