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General NPI Number Information
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NPI Number | 1699474445
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Entity Type | Organization
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Legal Business Name | OMEGA CARE SERVICES LLC
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 608 GARRON POINT PASS
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City | BEAR
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State | DE
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Zip | 19701-1994
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Country | US
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Telephone | 267-574-3622
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Fax |
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Provider Business Mailing Address
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Address Line | 1167 W BALTIMORE PIKE STE 227
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City | MEDIA
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State | PA
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Zip | 19063-5127
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Country | US
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Telephone | 267-574-3622
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. MODUPEOLA SALAMI
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Credential |
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Telephone | 267-574-3622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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