Provider Demographics
NPI:1881761427
Name:OMNI VISIONS, INC.
Entity type:Organization
Organization Name:OMNI VISIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WADDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-334-0249
Mailing Address - Street 1:301 S PERIMETER PARK DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4143
Mailing Address - Country:US
Mailing Address - Phone:615-726-3603
Mailing Address - Fax:615-726-3632
Practice Address - Street 1:795 MERRIMON AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-2462
Practice Address - Country:US
Practice Address - Phone:828-250-0629
Practice Address - Fax:828-250-0914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSO 09985A320900000X
KY50053320900000X
NCNA320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300987BMedicaid
NC8300987GMedicaid
NC8300987HMedicaid
NC8300987Medicaid