Provider Demographics
NPI:1891495446
Name:OVER HEARTS LLC
Entity Type:Organization
Organization Name:OVER HEARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLAMIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBILANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-243-5991
Mailing Address - Street 1:3640 CONCORD PIKE # 1091
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-5022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 SERVAN CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2945
Practice Address - Country:US
Practice Address - Phone:267-243-5991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities