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NPI Code Detail

MEDICARE: OMEGA SENIOR CENTER

MEDICARE: OMEGA SENIOR CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA0600XAdult Day Care Clinic/Center

General Provider Information

NPI Number : 1578069316
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMEGA SENIOR CENTER
Provider Business Mailing Address
First Line : 4917 JONESBORO RD
Second Line :
City : FOREST PARK
State : GA
Zip : 30297-4310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4917 JONESBORO RD
Second Line :
City : FOREST PARK
State : GA
Zip : 30297-4310
Country : US
Telephone Number : 678-833-5668
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. SOM DALAMON
Credential :
Telephone Number : 678-313-2138
Provider Enumeration Date : 04/02/2018
Last Update Date : 04/02/2018

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Directions to “OMEGA SENIOR CENTER ” Practice Location

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