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General NPI Number Information
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NPI Number | 1932960739
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Entity Type | Organization
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Legal Business Name | OMNI FAMILY OF SERVICES INDIANA INC.
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 6515 E 82ND ST STE 110
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-1544
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Country | US
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Telephone | 317-442-0895
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Fax |
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Provider Business Mailing Address
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Address Line | 301 S PERIMETER PARK DR STE 210
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City | NASHVILLE
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State | TN
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Zip | 37211-4128
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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 | EXECUTIVE DIRECTOR
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Name | ANDREA GOODWIN
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Credential |
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Telephone | 317-442-0895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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