Healthcare Provider Details

I. General information

NPI: 1326872177
Provider Name (Legal Business Name): OMEGA BEHAVIORAL HEALTH SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 E WILSON BRIDGE RD STE 100
WORTHINGTON OH
43085-2566
US

IV. Provider business mailing address

6478 WINCHESTER BLVD # 427
CANAL WINCHESTER OH
43110-2004
US

V. Phone/Fax

Practice location:
  • Phone: 614-560-5842
  • Fax:
Mailing address:
  • Phone: 614-560-5842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMANDA ROBINSON
Title or Position: MANAGER
Credential:
Phone: 614-560-5842