| Omega Independent Living Services | |
|
3029 Stony Brook Dr Ste 105 Raleigh NC 27604-3790 | |
| (919) 255-3268 | |
| (919) 250-2004 |
| Full Name | Omega Independent Living Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3029 Stony Brook Dr Ste 105, Raleigh, North Carolina |
| Authorized Official Name and Position | Donald K. Grantham (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 9192553268 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omega Independent Living Services 3029 Stony Brook Dr Ste 105 Raleigh NC 27604-3790 Ph: (919) 255-3268 | Omega Independent Living Services 3029 Stony Brook Dr Ste 105 Raleigh NC 27604-3790 Ph: (919) 255-3268 |
| NPI Number | 1891017497 |
|---|---|
| Provider Enumeration Date | 02/23/2010 |
| Last Update Date | 02/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891017497 | NPI | - | NPPES |
| 8300455B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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