| Omni House Inc | |
|
1421 Madison Park Dr Glen Burnie MD 21061-5613 | |
| (410) 768-6777 | |
| Not Available |
| Full Name | Omni House Inc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 1421 Madison Park Dr, Glen Burnie, Maryland |
| Authorized Official Name and Position | John Cuddy (CFO) |
| Authorized Official Contact | 4107686777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni House Inc Po Box 1270 1421 Madison Park Dr Glen Burnie MD 21060-1270 Ph: (410) 768-6777 | Omni House Inc 1421 Madison Park Dr Glen Burnie MD 21061-5613 Ph: (410) 768-6777 |
| NPI Number | 1942367222 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942367222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 17445 (Maryland) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | 17446 (Maryland) | Primary |
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