Provider Demographics
NPI:1659097566
Name:OPEN HEARTS HEALTHCARE LLC
Entity Type:Organization
Organization Name:OPEN HEARTS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-939-0810
Mailing Address - Street 1:121 S ACLINE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-2632
Mailing Address - Country:US
Mailing Address - Phone:910-774-4650
Mailing Address - Fax:
Practice Address - Street 1:2006 N PINE ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3936
Practice Address - Country:US
Practice Address - Phone:910-370-0274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPEN HEARTS HEALTHCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care