Provider Demographics
NPI:1013744101
Name:OMNIPRESENCE CARE MANAGEMENT
Entity type:Organization
Organization Name:OMNIPRESENCE CARE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARLISHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-981-3863
Mailing Address - Street 1:4485 LAWRENCEVILLE HWY. NW.
Mailing Address - Street 2:STE. 207 #3383
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047
Mailing Address - Country:US
Mailing Address - Phone:404-981-3863
Mailing Address - Fax:
Practice Address - Street 1:4485 LAWRENCEVILLE HWY. NW.
Practice Address - Street 2:STE. 207 #3383
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047
Practice Address - Country:US
Practice Address - Phone:404-981-3863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251X00000XAgenciesSupports BrokerageGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies