Provider Demographics
NPI:1639666175
Name:OPEN MOBILE CARE
Entity Type:Organization
Organization Name:OPEN MOBILE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHEY
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:720-893-0130
Mailing Address - Street 1:1121 STONE CANYON RD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-7319
Mailing Address - Country:US
Mailing Address - Phone:720-893-0130
Mailing Address - Fax:
Practice Address - Street 1:1121 STONE CANYON RD
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-7319
Practice Address - Country:US
Practice Address - Phone:720-893-0130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO905830251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health