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General NPI Number Information
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NPI Number | 1003259185
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Entity Type | Organization
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Legal Business Name | OPEN HEART RETIREMENT HOME INC
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 342 SW 34TH TER
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-2370
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Country | US
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Telephone | 954-428-5181
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Fax | 954-428-5181
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Provider Business Mailing Address
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Address Line | 342 SW 34TH TER
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-2370
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Country | US
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Telephone | 954-428-5181
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Fax | 954-428-5181
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ENA POWELL
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Credential |
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Telephone | 954-934-8590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL10899
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License Number State | FL
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