Provider Demographics
NPI:1790922995
Name:OMEGA CARE SERVICES, INC.
Entity Type:Organization
Organization Name:OMEGA CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:ELOHO
Authorized Official - Last Name:ODIVBRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-386-7621
Mailing Address - Street 1:3502 ESSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3246
Mailing Address - Country:US
Mailing Address - Phone:240-386-7621
Mailing Address - Fax:240-206-9578
Practice Address - Street 1:3502 ESSINGTON CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3246
Practice Address - Country:US
Practice Address - Phone:240-386-7621
Practice Address - Fax:240-206-9578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-10
Last Update Date:2009-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
MDD12864559320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities