Provider Demographics
NPI:1679112676
Name:OPEN HEART COMMUNITIES
Entity Type:Organization
Organization Name:OPEN HEART COMMUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CABELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-871-0439
Mailing Address - Street 1:31310 SHAW DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093
Mailing Address - Country:US
Mailing Address - Phone:248-579-7325
Mailing Address - Fax:
Practice Address - Street 1:31310 SHAW DR
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093
Practice Address - Country:US
Practice Address - Phone:248-579-7325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health