Healthcare Provider Details

I. General information

NPI: 1093919508
Provider Name (Legal Business Name): OMNI BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 F ST
OMAHA NE
68117-2807
US

IV. Provider business mailing address

5115 F ST
OMAHA NE
68117-2807
US

V. Phone/Fax

Practice location:
  • Phone: 402-397-9866
  • Fax: 402-397-1404
Mailing address:
  • Phone: 402-397-9866
  • Fax: 402-397-1404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MORGAN KELLY
Title or Position: GENERAL COUNSEL
Credential: JD, MA
Phone: 402-397-9866