MEDICARE: OPEN ARMS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1134358237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN ARMS

Provider Business Mailing Address
First Line	:	8306 WILSHIRE BLVD # 7024
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2382
Country	:	US
Telephone Number	:	323-755-2742
Fax Number	:	310-876-0533

Provider Business Practice Location Address
First Line	:	1339 E 120TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90059-2401
Country	:	US
Telephone Number	:	323-755-2742
Fax Number	:	310-876-0533

Authorized Official
Title or Position	:	CEO
Name	:	RHONDA LABOMME
Credential	:
Telephone Number	:	323-755-2742

Provider Enumeration Date	:	07/09/2009
Last Update Date	:	07/09/2009

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Directions to “OPEN ARMS ” Practice Location

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