Healthcare Provider Details

I. General information

NPI: 1730339094
Provider Name (Legal Business Name): OPEN YOUR HEART
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3722 MONROE RD
CHARLOTTE NC
28205-7736
US

IV. Provider business mailing address

401 HAWTHORNE LN # 110-273
CHARLOTTE NC
28204-2484
US

V. Phone/Fax

Practice location:
  • Phone: 704-372-7239
  • Fax:
Mailing address:
  • Phone: 704-372-7239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: MRS. CRYSTAL B WALKER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 704-372-7239