Provider Demographics
NPI:1710453923
Name:OMNI HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:OMNI HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:THEVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-997-2000
Mailing Address - Street 1:PO BOX 454
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18936-0454
Mailing Address - Country:US
Mailing Address - Phone:267-718-5022
Mailing Address - Fax:
Practice Address - Street 1:120 S 6TH ST
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-4605
Practice Address - Country:US
Practice Address - Phone:267-718-5022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OMNI HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-16
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)