Provider Demographics
NPI:1487938643
Name:OPEN ARMS PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:OPEN ARMS PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KEIZER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:712-266-5504
Mailing Address - Street 1:4242 GORDON DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-1376
Mailing Address - Country:US
Mailing Address - Phone:712-266-5504
Mailing Address - Fax:
Practice Address - Street 1:4242 GORDON DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-1376
Practice Address - Country:US
Practice Address - Phone:712-266-5504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001195103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty