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General NPI Number Information
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NPI Number | 1558022392
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Entity Type | Organization
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Legal Business Name | OPEN HEARTS FAMILY CARE, LLC
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 12214 DAWN VISTA DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-3329
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Country | US
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Telephone | 813-758-6156
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Fax |
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Provider Business Mailing Address
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Address Line | 12214 DAWN VISTA DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-3329
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARLINE FILS AIME
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Credential |
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Telephone | 813-758-6156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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