Provider Demographics
NPI:1588141014
Name:OPEN ARMS
Entity type:Organization
Organization Name:OPEN ARMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VERA
Authorized Official - Middle Name:LORRIANE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-325-6600
Mailing Address - Street 1:3905 WHITE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-3437
Mailing Address - Country:US
Mailing Address - Phone:410-488-4950
Mailing Address - Fax:410-488-8429
Practice Address - Street 1:3905 WHITE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-3437
Practice Address - Country:US
Practice Address - Phone:410-488-4950
Practice Address - Fax:410-488-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30AL3589-A310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility