MEDICARE: OMEGA COUNSELING SERVICES

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	2376-A	TX

General Provider Information

NPI Number	:	1326023847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMEGA COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	8201 LOCKHEED DR
Second Line	:	STE 115
City	:	EL PASO
State	:	TX
Zip	:	79925-2500
Country	:	US
Telephone Number	:	915-775-9891
Fax Number	:	915-775-9891

Provider Business Practice Location Address
First Line	:	8201 LOCKHEED DR
Second Line	:	STE 115
City	:	EL PASO
State	:	TX
Zip	:	79925-2500
Country	:	US
Telephone Number	:	915-775-9891
Fax Number	:	915-775-9891

Authorized Official
Title or Position	:	OWNER
Name	:	MR. FRANCISCO-JAVIER VILLA-RIVERA
Credential	:	LCDC/AAC
Telephone Number	:	915-775-9891

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	08/22/2020

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Directions to “OMEGA COUNSELING SERVICES ” Practice Location

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