Provider Demographics
NPI:1841403490
Name:OMETTA HEALTH CARE SERVICES, INC
Entity Type:Organization
Organization Name:OMETTA HEALTH CARE SERVICES, INC
Other - Org Name:OMETTA HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CURRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-551-1123
Mailing Address - Street 1:3140 HARBOR LN N
Mailing Address - Street 2:STE 250
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-5126
Mailing Address - Country:US
Mailing Address - Phone:763-551-1123
Mailing Address - Fax:763-551-1109
Practice Address - Street 1:3140 HARBOR LN N
Practice Address - Street 2:STE 250
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-5126
Practice Address - Country:US
Practice Address - Phone:763-551-1123
Practice Address - Fax:763-551-1109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility