Provider Demographics
NPI:1114136942
Name:BERING OMEGA COMMUNITY SERVICES
Entity Type:Organization
Organization Name:BERING OMEGA COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE CENTER MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHEVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-341-3772
Mailing Address - Street 1:1429 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-3711
Mailing Address - Country:US
Mailing Address - Phone:713-529-6071
Mailing Address - Fax:713-529-3626
Practice Address - Street 1:1429 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3711
Practice Address - Country:US
Practice Address - Phone:713-529-6071
Practice Address - Fax:713-529-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119266385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care