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General NPI Number Information
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NPI Number | 1497277933
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Entity Type | Organization
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Legal Business Name | OMNIV HEALTH SYSTEMS LLC.
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Dates
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Enumeration Date | 07/15/2017
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 4141 SOUTHWEST FWY STE 515
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City | HOUSTON
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State | TX
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Zip | 77027
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Country | US
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Telephone | 713-732-4174
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Fax | 713-960-1122
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Provider Business Mailing Address
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Address Line | 810 DAKOTA ST
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City | SOUTH HOUSTON
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State | TX
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Zip | 77587-3012
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER/DIRECTOR
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Name | MR. COURTNEY ALLEN JACOBS I
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Credential |
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Telephone | 713-732-4174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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