Healthcare Provider Details

I. General information

NPI: 1528986015
Provider Name (Legal Business Name): OMEGA BEHAVIOR SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8913 BROADWAY # 1072
MERRILLVILLE IN
46410-7039
US

IV. Provider business mailing address

3470 E 69TH AVE
MERRILLVILLE IN
46410-3955
US

V. Phone/Fax

Practice location:
  • Phone: 219-900-2448
  • Fax:
Mailing address:
  • Phone: 219-900-2448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AQUANITA G WHITE
Title or Position: CEO
Credential: M.S.
Phone: 219-900-2448