Healthcare Provider Details

I. General information

NPI: 1073433462
Provider Name (Legal Business Name): OMEGA HEALTH QUEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 E 45TH ST
CLEVELAND OH
44127-1088
US

IV. Provider business mailing address

3100 E 45TH ST
CLEVELAND OH
44127-1088
US

V. Phone/Fax

Practice location:
  • Phone: 440-538-7410
  • Fax:
Mailing address:
  • Phone: 440-538-7410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State

VIII. Authorized Official

Name: LEGACYY NASTASSIA MARSHALL
Title or Position: OWNER
Credential:
Phone: 440-538-7410