Provider Demographics
NPI:1588075659
Name:OPEN ARMS
Entity type:Organization
Organization Name:OPEN ARMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLAITAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ODENIYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-330-0212
Mailing Address - Street 1:2454 HERITAGE GREEN AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-1740
Mailing Address - Country:US
Mailing Address - Phone:508-330-0212
Mailing Address - Fax:
Practice Address - Street 1:2454 HERITAGE GREEN AVE
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-1740
Practice Address - Country:US
Practice Address - Phone:508-330-0212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL232834372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty