MEDICARE: OPEN HEART HOME CARE SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	234405	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881049351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN HEART HOME CARE SERVICES INC

Provider Business Mailing Address
First Line	:	5775 NW 58TH AVE APT G105
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33319-2341
Country	:	US
Telephone Number	:	954-825-9385
Fax Number	:

Provider Business Practice Location Address
First Line	:	3929 N ANDREWS AVE
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33309-5239
Country	:	US
Telephone Number	:	954-999-1256
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CHOSTENE FRANCOIS
Credential	:
Telephone Number	:	954-825-9385

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	06/30/2016

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