Organization
OPENHEAVEN HEALTHCARE LLC
Active
Other names
OPENHEAVEN HEALTHCARE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADEDOKUN I ADEKOYA (ADMINISTRATOR)
(240) 601-8037
Entity
Organization
Contact information
Practice address
11106 GLISSADE DR, CLINTON, MD 20735-1078
(240) 253-2632
(240) 345-5732
Mailing address
11106 GLISSADE DR, CLINTON, MD 20735-1078
(240) 253-2632
(240) 345-5732
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
R4091R
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R4091R
RESIDENTIAL SERVICE AGENCY LICENSE
MD
Enumeration date
06/08/2018
Last updated
06/08/2018
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