Provider Demographics
NPI:1437361805
Name:OMEGA SERVICE COORDINATION, INCORPORATED
Entity Type:Organization
Organization Name:OMEGA SERVICE COORDINATION, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:HO CHEE
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:208-737-0990
Mailing Address - Street 1:149 MAIN AVE E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6261
Mailing Address - Country:US
Mailing Address - Phone:208-737-0990
Mailing Address - Fax:208-737-0996
Practice Address - Street 1:149 MAIN AVE E
Practice Address - Street 2:SUITE 100
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6261
Practice Address - Country:US
Practice Address - Phone:208-737-0990
Practice Address - Fax:208-737-0996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLSW-1032251B00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services