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General NPI Number Information
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NPI Number | 1023215910
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Entity Type | Organization
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Legal Business Name | OPENARMSOFGOLDSBORO
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 203 N JACKSON ST B
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City | GOLDSBORO
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State | NC
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Zip | 27530-3857
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Country | US
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Telephone | 919-734-8447
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Fax |
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Provider Business Mailing Address
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Address Line | 203 N JACKSON ST B
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City | GOLDSBORO
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State | NC
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Zip | 27530
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Country | US
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Telephone | 919-734-8447
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MATTHEW BROWN III
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Credential |
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Telephone | 919-736-8447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | MHL096155
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License Number State | NC
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