Provider Demographics
NPI:1962699983
Name:OPEN ARMS BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:OPEN ARMS BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:JEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:580-351-9998
Mailing Address - Street 1:2215 NW CACHE RD.
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505
Mailing Address - Country:US
Mailing Address - Phone:580-351-9998
Mailing Address - Fax:580-351-9898
Practice Address - Street 1:2215 NW CACHE RD.
Practice Address - Street 2:SUITE 107
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505
Practice Address - Country:US
Practice Address - Phone:580-351-9998
Practice Address - Fax:580-351-9898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health