NPIMap

Organization Active NPI

Omni House Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glen Burnie, MD
National Provider Identifier
1104983568
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
4233 Issued in MD
Legal business name
OMNI HOUSE INC
Practice address
1419 Madison Park Dr
Glen Burnie, MD 21061-5613
Phone
(410) 768-2719
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. John Cuddy, MBA, FHFMA
Title
Cfo
Phone
(410) 768-6777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 4233 MD Primary

Addresses

Primary practice location

1419 Madison Park Dr
Glen Burnie, MD 21061-5613

Mailing address

PO Box 1270
1419 Madison Park Dr
Glen Burnie, MD 21060-1270
Phone (410) 768-2719

Other names 1

  • Omni House Behavioral Health System Doing business as

National Provider Directory

National Provider Directory

Locations

9 3rd Ave SW
Glen Burnie, MD 21061
Phone (410) 768-2719

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104983568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1270",
            "address_2": "1419 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210601270",
            "telephone_number": "410-768-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615613",
            "telephone_number": "410-768-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CUDDY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "410-768-6777",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, FHFMA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": "4233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni House Behavioral Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.