Provider Demographics
NPI:1982080230
Name:OMEGA HOME CARE SERVICES
Entity Type:Organization
Organization Name:OMEGA HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SOM
Authorized Official - Middle Name:
Authorized Official - Last Name:DALAMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-313-2138
Mailing Address - Street 1:4106 FRANKS DR
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-7509
Mailing Address - Country:US
Mailing Address - Phone:678-313-2138
Mailing Address - Fax:866-712-9757
Practice Address - Street 1:4106 FRANKS DR
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-7509
Practice Address - Country:US
Practice Address - Phone:678-313-2138
Practice Address - Fax:866-712-9757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-09
Last Update Date:2015-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-R-1201253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care