Omnis Health Life, LLC
Organization Active NPI Methadone Clinic · Baltimore, MD
NPI 1154861557 · NPPES record last updated Sep 2, 2025
Key facts
- NPI
- 1154861557
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Methadone Clinic 261QM2800X
- Legal business name
- OMNIS HEALTH LIFE, LLC
- Practice address
- 2200 Garrison Blvd Ste 100 200 300
Baltimore, MD 21216-2619 - Phone
- (667) 212-4187
- NPI assigned
- Mar 3, 2017
- Organization subpart
- No
Authorized official
- Name
- Mr. Rachel Wilson
- Title
- Chairwoman
- Phone
- (678) 561-3037
Other NPIs on the same Medicare enrollment 2
Practitioners 7
-
Joseph A Adams, M.D.
-
Sarah A Merritt, M.D.
-
Nicholas G Scotto, M.D.
-
Ugochukwu Okoroh, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190211000010 | MD | Part B Supplier - Clinic/Group Practice | 5395083778 |
Receives reassigned benefits from 6 practitioners 2 other NPIs on this enrollment Practice locations: Baltimore, MD |
National Provider Directory
Locations
2200 Garrison Blvd
Ste 100
Baltimore, MD 21216
2200 Garrison Blvd
Ste 101
Baltimore, MD 21216
Phone (240) 204-5594
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Social Worker |
104100000X | |||
| Methadone Clinic | 261QM2800X | Yes |
Addresses
Primary practice location
2200 Garrison Blvd Ste 100 200 300
Baltimore, MD 21216-2619
Mailing address
162 Ponte Vedra Dr
Fayetteville, GA 30215-8040
Phone (678) 561-2823
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- Omnis Health Life, LLC
- Omnis Health Life, LLC
- Nkeiru Omo
- Tajudeen Omodeoye
- Jennifer Omoijuanfo
All providers in Baltimore, MD · Methadone Clinic in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.