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General NPI Number Information
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NPI Number | 1124887484
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Entity Type | Organization
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Legal Business Name | OPEN ARMS RECOVERY CENTER LLC
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 166 GRIFFIN AVE
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City | SOMERSET
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State | KY
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Zip | 42501-2259
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Country | US
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Telephone | 859-494-2656
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Fax |
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Provider Business Mailing Address
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Address Line | 166 GRIFFIN AVE
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City | SOMERSET
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State | KY
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Zip | 42501-2259
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Country | US
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Telephone | 859-494-2656
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BONITA LESHA CLAIBORNE
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Credential |
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Telephone | 859-494-2656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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