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NPI 1396434270

NPI 1396434270 : OPEN ARMS HEALTHCARE SERVICES,LLC : BURKE, VA

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General NPI Number Information
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    NPI Number           |    1396434270
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    Entity Type          |    Organization 
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    Legal Business Name  |    OPEN ARMS HEALTHCARE SERVICES,LLC 
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Dates
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    Enumeration Date     |    05/05/2023
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    Last Update Date     |    05/05/2023
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Provider Practice Location Address
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    Address Line         |    5424 BRIXHAM CT 
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    City                 |    BURKE
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    State                |    VA
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    Zip                  |    22015-1921
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    Country              |    US
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    Telephone            |    240-640-0511
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5424 BRIXHAM CT 
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    City                 |    BURKE
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    State                |    VA
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    Zip                  |    22015-1921
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    Country              |    US
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    Telephone            |    240-640-0511
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ADMINISTRATOR
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    Name                 |     BOLAJI FOLASADE ADEDEJI 
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    Credential           |    
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    Telephone            |    240-640-0511
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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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