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General NPI Number Information
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NPI Number | 1962813071
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Entity Type | Organization
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Legal Business Name | OMNIA HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 05/12/2014
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 305 N. LINCOLN STREET SUITE B
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City | POST FALLS
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State | ID
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Zip | 83854-6412
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Country | US
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Telephone | 208-907-1790
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Fax |
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Provider Business Mailing Address
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Address Line | 305 N. LINCOLN STREET SUITE B
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City | POST FALLS
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State | ID
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Zip | 83854-6412
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Country | US
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Telephone | 208-907-1790
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JOSEPH AARON NICHOLES
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Credential | MBA
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Telephone | 208-907-1790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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