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General NPI Number Information
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NPI Number | 1487087334
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Entity Type | Organization
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Legal Business Name | OPEN ARMS ADULT CENTER
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 10211 BOOKERS LN
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City | AMELIA COURT HOUSE
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State | VA
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Zip | 23002-3121
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Country | US
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Telephone | 804-241-6285
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Fax |
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Provider Business Mailing Address
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Address Line | 10211 BOOKERS LN
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City | AMELIA COURT HOUSE
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State | VA
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Zip | 23002-3121
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Country | US
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Telephone | 804-241-6285
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JULIANE BOOKER HICKS
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Credential | CNA
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Telephone | 804-241-6285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 1401050528
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 2679
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License Number State | VA
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