NPIMap

Organization Active NPI

Open Arms Home Health Care - Council Bluffs, LLC

  • Home Health Agency
  • Council Bluffs, IA
National Provider Identifier
1043662893
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
OPEN ARMS HOME HEALTH CARE - COUNCIL BLUFFS, LLC
Practice address
2306 Sherwood Dr
Council Bluffs, IA 51503-1048
Phone
(952) 447-2345
Fax
(952) 447-2344
NPI assigned
Jul 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Gregory A McClenahan, JD,MBA
Title
Chief Manager of LLC
Phone
(952) 447-2345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

2306 Sherwood Dr
Council Bluffs, IA 51503-1048

Mailing address

16670 Franklin TRL SE
Suite 240
Prior Lake, MN 55372-2924
Phone (952) 447-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160907000216 IA Part A Provider - Home Health Agency 5496041196 Practice locations: Council Bluffs, IA

Home health agency certification: CCN 167432

Legal name
OPEN ARMS HOME HEALTH CARE - COUNCIL BLUFFS, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 8, 2017
Last certification
Oct 31, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jun 30, 2016 in IA
Enrollment address
2306 Sherwood Dr
Council Bluffs, IA 51503-1048

Care Compare: Home health agency

Medicare Care Compare
Listed as
Open Arms Home Health Care - Council Bluffs, LLCCCN 167432
Ownership
Proprietary
Certified
Feb 8, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D2128699Open Arms Home Health- Council Bluffs, LLC2306 Sherwood Drive, Council Bluffs, IA 51503Certificate of waiverApr 3, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Evergreen Real Estate Development Corporation Organization, Prior Lake, MN For-profit 5% Or Greater Direct Ownership Interest Jun 30, 2016 100%
Amber Marie Childers Individual W-2 Managing EmployeeAdministrator Aug 30, 2021
Gregory McClenahan Individual 5% Or Greater Indirect Ownership InterestPres of Corporate Owner of Provider Jun 30, 2016 100%
Corporate OfficerChief Manager Jun 30, 2016
Corporate DirectorGovernor Jun 30, 2016

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1043662893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16670 FRANKLIN TRL SE",
            "address_2": "SUITE 240",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722924",
            "telephone_number": "952-447-2345",
            "fax_number": "952-447-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 SHERWOOD DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515031048",
            "telephone_number": "952-447-2345",
            "fax_number": "952-447-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN ARMS HOME HEALTH CARE - COUNCIL BLUFFS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "MCCLENAHAN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF MANAGER OF LLC",
        "authorized_official_telephone_number": "952-447-2345",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD,MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.