Healthcare Provider Details

I. General information

NPI: 1720659113
Provider Name (Legal Business Name): OPEN ARMS HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 W 25TH ST STE B
NORFOLK VA
23517-1000
US

IV. Provider business mailing address

1035 W 25TH ST STE B
NORFOLK VA
23517-1000
US

V. Phone/Fax

Practice location:
  • Phone: 757-752-3586
  • Fax:
Mailing address:
  • Phone: 757-937-3262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: CANDICE WALISHA POOLE
Title or Position: OWNER
Credential:
Phone: 757-937-3262