Provider Demographics
NPI:1053075390
Name:OPEN HEART, LLC
Entity Type:Organization
Organization Name:OPEN HEART, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-609-3207
Mailing Address - Street 1:504 BYRD ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-5740
Mailing Address - Country:US
Mailing Address - Phone:662-609-3207
Mailing Address - Fax:
Practice Address - Street 1:504 BYRD ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-5740
Practice Address - Country:US
Practice Address - Phone:662-609-3207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No332U00000XSuppliersHome Delivered Meals
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care