MEDICARE: THE OPEN DOOR NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
3	332U00000X	Home Delivered Meals
4	385H00000X	Respite Care
5	251X00000X	Supports Brokerage Agency

General Provider Information

NPI Number	:	1023894813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE OPEN DOOR NETWORK

Provider Business Mailing Address
First Line	:	1921 19TH ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-4209
Country	:	US
Telephone Number	:	661-322-0931
Fax Number	:

Provider Business Practice Location Address
First Line	:	1921 19TH ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-4209
Country	:	US
Telephone Number	:	661-322-0931
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	LAUREN SKIDMORE
Credential	:
Telephone Number	:	661-330-2953

Provider Enumeration Date	:	09/06/2023
Last Update Date	:	09/06/2023

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Directions to “THE OPEN DOOR NETWORK ” Practice Location

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