Provider Demographics
NPI:1023468618
Name:OPEN MY H.E.A.R.T., INC. (HELPING EMPOWER AND REBUILD TENACITY)
Entity type:Organization
Organization Name:OPEN MY H.E.A.R.T., INC. (HELPING EMPOWER AND REBUILD TENACITY)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:RENE'
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-949-4502
Mailing Address - Street 1:14311 REESE BLVD, SUITE A2 #316
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7955
Mailing Address - Country:US
Mailing Address - Phone:704-949-4502
Mailing Address - Fax:
Practice Address - Street 1:13514 DELSTONE DR
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3282
Practice Address - Country:US
Practice Address - Phone:704-949-4502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness