Provider Demographics
NPI:1043662893
Name:OPEN ARMS HOME HEALTH CARE - COUNCIL BLUFFS, LLC
Entity type:Organization
Organization Name:OPEN ARMS HOME HEALTH CARE - COUNCIL BLUFFS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER OF LLC
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCLENAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:JD,MBA
Authorized Official - Phone:952-447-2345
Mailing Address - Street 1:16670 FRANKLIN TRL SE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-2924
Mailing Address - Country:US
Mailing Address - Phone:952-447-2345
Mailing Address - Fax:952-447-2344
Practice Address - Street 1:2306 SHERWOOD DR
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-1048
Practice Address - Country:US
Practice Address - Phone:952-447-2345
Practice Address - Fax:952-447-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health