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General NPI Number Information
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NPI Number | 1043939655
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Entity Type | Organization
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Legal Business Name | OPEN HEARTS OPEN ARMS
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 200 E BROADWAY AVE STE B-31
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City | MARYVILLE
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State | TN
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Zip | 37804-5709
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Country | US
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Telephone | 865-324-6100
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Fax | 865-238-0313
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Provider Business Mailing Address
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Address Line | 200 E BROADWAY AVE STE B-31
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City | MARYVILLE
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State | TN
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Zip | 37804-5709
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Country | US
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Telephone | 865-324-6100
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Fax | 865-238-0313
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Authorized Official
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Title or Position | ASSISTANT EXECUTIVE DIRECTOR
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Name | JAMI RENE ANDRUS
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Credential |
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Telephone | 865-324-6101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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