NPIMap

Organization Active NPI

Open Arms Behavioral Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gonzales, LA
National Provider Identifier
1154855591
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
OPEN ARMS BEHAVIORAL SERVICES
Practice address
630 W Cornerview St
Gonzales, LA 70737-2742
Phone
(225) 647-4105
Fax
(866) 234-8190
NPI assigned
Apr 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Authorized official

Name
Demarcus D PattersonNPI 1750827085
Title
Owner
Phone
(225) 647-4105

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 2203783205 LA
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

630 W Cornerview St
Gonzales, LA 70737-2742

Mailing address

PO Box 359
Gonzales, LA 70707-0359
Phone (225) 647-4105

Other practice location 1

108 E Sanders St
Gonzales, LA 70737-3144
Phone (225) 647-4105

Other identifiers 1

IdentifierTypeStateIssuer
1154855591MedicaidLA

Other names 1

  • Open Arms Behavioral Services, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200318000436 LA Part B Supplier - Clinic/Group Practice 4880022250 Receives reassigned benefits from 1 practitioner
Practice locations: Gonzales, LA

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
19D2216726Open Arms Behavioral Services, LLC630 W Cornerview St, Gonzales, LA 70737Certificate of waiverMar 15, 2027

National Provider Directory

National Provider Directory

Locations

630 W Cornerview St
Gonzales, LA 70737
Phone (225) 623-7296

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1154855591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 359",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707070359",
            "telephone_number": "225-647-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W CORNERVIEW ST",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707372742",
            "telephone_number": "225-647-4105",
            "fax_number": "866-234-8190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 E Sanders St",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "LA",
            "postal_code": "707373144",
            "country_code": "US",
            "telephone_number": "225-647-4105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPEN ARMS BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "DEMARCUS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-647-4105"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "2203783205",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154855591",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open Arms Behavioral Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.