MEDICARE: OPEN ARMS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	101YA0400X	Addiction (Substance Use Disorder) Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699369728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN ARMS, LLC

Provider Business Mailing Address
First Line	:	4430 PARK HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-6324
Country	:	US
Telephone Number	:	443-627-3593
Fax Number	:

Provider Business Practice Location Address
First Line	:	4430 PARK HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-6324
Country	:	US
Telephone Number	:	443-627-3593
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	GREGORY MARTIN DIGGS
Credential	:
Telephone Number	:	443-627-3593

Provider Enumeration Date	:	03/01/2021
Last Update Date	:	03/01/2021

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Directions to “OPEN ARMS, LLC ” Practice Location

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