Provider Demographics
NPI:1548337637
Name:OMNI FAMILY OF SERVICES NORTH CAROLINA INC.
Entity type:Organization
Organization Name:OMNI FAMILY OF SERVICES NORTH CAROLINA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROJECTS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-851-8905
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 1:1299 PARKWAY DR STE H
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-3491
Practice Address - Country:US
Practice Address - Phone:919-330-0311
Practice Address - Fax:919-288-2528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC253J00000X, 320900000X
TNSO 09985A320900000X
KY500533320900000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities