Provider Demographics
NPI:1528011574
Name:OMEGA HOME HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:OMEGA HOME HEALTH SERVICES INC.
Other - Org Name:OMEGA HOME HEALTH SERVICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAYEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:281-564-1635
Mailing Address - Street 1:12425 S SAM HOUSTON PKWY W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-2001
Mailing Address - Country:US
Mailing Address - Phone:281-564-1635
Mailing Address - Fax:281-564-1658
Practice Address - Street 1:12425 S SAM HOUSTON PKWY W
Practice Address - Street 2:STE 238
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-2001
Practice Address - Country:US
Practice Address - Phone:281-564-1635
Practice Address - Fax:281-564-1658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007590251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001003997OtherMDCP
TX001004042Medicaid
TX459466Medicare ID - Type Unspecified