Provider Demographics
NPI:1942538152
Name:LIFE OPEN HEART,OPEN HOME
Entity Type:Organization
Organization Name:LIFE OPEN HEART,OPEN HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:PENDARVIS
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:972-551-3155
Mailing Address - Street 1:9428 HIGHWAY 80
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75161-6353
Mailing Address - Country:US
Mailing Address - Phone:972-551-3155
Mailing Address - Fax:
Practice Address - Street 1:9422 HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75161-6353
Practice Address - Country:US
Practice Address - Phone:972-551-3155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-28
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility