Provider Demographics
NPI:1104680958
Name:OPEN MINDED HEALTH CARE, LLC
Entity type:Organization
Organization Name:OPEN MINDED HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:OSAZE
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:OKORO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:443-557-8719
Mailing Address - Street 1:PO BOX 1305
Mailing Address - Street 2:
Mailing Address - City:SOLOMONS
Mailing Address - State:MD
Mailing Address - Zip Code:20688-1305
Mailing Address - Country:US
Mailing Address - Phone:667-910-8540
Mailing Address - Fax:667-200-4711
Practice Address - Street 1:90 HOLIDAY DR
Practice Address - Street 2:STE C-1
Practice Address - City:SOLOMONS
Practice Address - State:MD
Practice Address - Zip Code:20688
Practice Address - Country:US
Practice Address - Phone:667-910-8540
Practice Address - Fax:667-200-4711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty