MEDICARE: OPEN ARMS GROUP INC

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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1356871362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN ARMS GROUP INC

Provider Business Mailing Address
First Line	:	9211 WALKER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-3952
Country	:	US
Telephone Number	:	215-913-5197
Fax Number	:	215-743-1322

Provider Business Practice Location Address
First Line	:	9211 WALKER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-3952
Country	:	US
Telephone Number	:	215-913-5197
Fax Number	:	215-743-1322

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SHAWN MCKENNA
Credential	:
Telephone Number	:	215-913-5197

Provider Enumeration Date	:	06/13/2017
Last Update Date	:	07/21/2022

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