Provider Demographics
NPI:1114348141
Name:OPEN HEARTS HOME CARE SERVICE LLC
Entity Type:Organization
Organization Name:OPEN HEARTS HOME CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN, MSN, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:484-772-5833
Mailing Address - Street 1:234 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3300
Mailing Address - Country:US
Mailing Address - Phone:484-772-5833
Mailing Address - Fax:
Practice Address - Street 1:234 N 6TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3300
Practice Address - Country:US
Practice Address - Phone:484-772-5833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA25073601251B00000X, 251C00000X, 251E00000X, 253Z00000X, 347C00000X
251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA06550601OtherHOME HEALTH LICENSE
PA1029273370001Medicaid