Healthcare Provider Details

I. General information

NPI: 1487589883
Provider Name (Legal Business Name): OMON SOCIAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CANNON ST
WEST ORANGE NJ
07052-3646
US

IV. Provider business mailing address

15 CANNON ST
WEST ORANGE NJ
07052-3646
US

V. Phone/Fax

Practice location:
  • Phone: 516-675-6740
  • Fax:
Mailing address:
  • Phone: 516-675-6740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: AKIN POPOOLA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 516-675-6740