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General NPI Number Information
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NPI Number | 1962699983
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Entity Type | Organization
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Legal Business Name | OPEN ARMS BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 2215 NW CACHE RD. SUITE 107
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City | LAWTON
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State | OK
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Zip | 73505
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Country | US
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Telephone | 580-351-9998
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Fax | 580-351-9898
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Provider Business Mailing Address
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Address Line | 2215 NW CACHE RD. SUITE 107
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City | LAWTON
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State | OK
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Zip | 73505
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Country | US
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Telephone | 580-351-9998
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Fax | 580-351-9898
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. RICARDO ALBERTO JEREZ
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Credential | PH.D., LPC
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Telephone | 580-351-9998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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