Healthcare Provider Details

I. General information

NPI: 1104731363
Provider Name (Legal Business Name): OMNI HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GREEN LN STE 2
BRISTOL PA
19007-5609
US

IV. Provider business mailing address

PO BOX 454
MONTGOMERYVILLE PA
18936-0454
US

V. Phone/Fax

Practice location:
  • Phone: 215-997-2000
  • Fax: 215-997-2282
Mailing address:
  • Phone: 215-997-2000
  • Fax: 215-997-2282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JAN MONTGOMERY
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 215-997-2000