Provider Demographics
NPI:1619486404
Name:OMNI BEHAVIORAL HEALTH SOLUTIONS, LLC
Entity Type:Organization
Organization Name:OMNI BEHAVIORAL HEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FLESCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-766-6067
Mailing Address - Street 1:PO BOX 6902
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-6902
Mailing Address - Country:US
Mailing Address - Phone:732-766-6067
Mailing Address - Fax:732-791-1408
Practice Address - Street 1:90 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2144
Practice Address - Country:US
Practice Address - Phone:732-766-6067
Practice Address - Fax:732-791-1408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00382200101YM0800X
NJ35SI00268300103T00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty