Healthcare Provider Details

I. General information

NPI: 1376182584
Provider Name (Legal Business Name): OPEN ARMS ADULT CARE WEST1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2428 ELYRIA AVE
LORAIN OH
44055-1366
US

IV. Provider business mailing address

16235 DRAKE RD
STRONGSVILLE OH
44136-7303
US

V. Phone/Fax

Practice location:
  • Phone: 440-452-5637
  • Fax: 440-452-5637
Mailing address:
  • Phone: 440-452-5637
  • Fax: 440-306-9017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SP0810X
TaxonomyChild & Family Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: SPARKLE CAREY
Title or Position: MANAGEMENT
Credential:
Phone: 440-452-5637