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General NPI Number Information
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NPI Number | 1548337637
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Entity Type | Organization
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Legal Business Name | OMNI FAMILY OF SERVICES NORTH CAROLINA INC.
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 1299 PARKWAY DR STE H
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City | GOLDSBORO
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State | NC
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Zip | 27534-3491
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Country | US
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Telephone | 919-330-0311
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Fax | 919-288-2528
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Provider Business Mailing Address
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Address Line | 301 S PERIMETER PARK DR SUITE 210
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City | NASHVILLE
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State | TN
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Zip | 37211-4143
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Country | US
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Telephone | 615-726-3603
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Fax | 615-726-3632
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Authorized Official
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Title or Position | SPECIAL PROJECTS COORDINATOR
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Name | BRELYN REED
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Credential |
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Telephone | 800-851-8905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | SO 09985A
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 500533
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License Number State | KY
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Taxonomy #5
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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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