Provider Demographics
NPI:1730664038
Name:OPEN HEART CARE NETWORK L,L,C
Entity Type:Organization
Organization Name:OPEN HEART CARE NETWORK L,L,C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TILLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-926-2240
Mailing Address - Street 1:34614 LAKE SIDE DR
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-8933
Mailing Address - Country:US
Mailing Address - Phone:213-926-2240
Mailing Address - Fax:281-934-1405
Practice Address - Street 1:34614 LAKE SIDE DR
Practice Address - Street 2:
Practice Address - City:BROOKSHIRE
Practice Address - State:TX
Practice Address - Zip Code:77423-8933
Practice Address - Country:US
Practice Address - Phone:213-926-2240
Practice Address - Fax:281-934-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX802155276OtherLLC