Healthcare Provider Details

I. General information

NPI: 1063198489
Provider Name (Legal Business Name): OPEN HEARTS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3934 LANDGRAF CV
DECATUR GA
30034-4738
US

IV. Provider business mailing address

3934 LANDGRAF CV
DECATUR GA
30034-4738
US

V. Phone/Fax

Practice location:
  • Phone: 404-901-7094
  • Fax: 770-558-3910
Mailing address:
  • Phone: 404-901-7094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. NNEKA OCHEI
Title or Position: CEO
Credential:
Phone: 404-901-7094