Healthcare Provider Details

I. General information

NPI: 1790452837
Provider Name (Legal Business Name): OMKAAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2840 SANDESTIN DR
RENO NV
89523-2135
US

IV. Provider business mailing address

2840 SANDESTIN DR
RENO NV
89523-2135
US

V. Phone/Fax

Practice location:
  • Phone: 347-654-7109
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. DHARMENDRA GOYAL
Title or Position: PROVIDER
Credential: MD
Phone: 347-654-7109