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General NPI Number Information
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NPI Number | 1720758394
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Entity Type | Organization
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Legal Business Name | OPEN ARMS RECOVERY
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Dates
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Enumeration Date | 09/15/2021
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 3300 COUNTY ROAD 10 STE 100
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-3064
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Country | US
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Telephone | 763-515-4733
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Fax | 763-999-4113
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Provider Business Mailing Address
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Address Line | 3300 COUNTY ROAD 10 STE 100
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-3064
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Country | US
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Telephone | 651-447-8643
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Fax | 763-999-4113
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Authorized Official
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Title or Position | OWNER
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Name | AIMMY MARIE CASALE
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Credential | LADC
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Telephone | 651-447-8643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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