Active NPI
Omega Care Services, Inc
Doing business as Living Waters Home Care Agency
- Home Health Agency
- Bronx, NY
National Provider Identifier
1184775637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1285L001
- Legal business name
- OMEGA CARE SERVICES, INC
- Doing business as
- Living Waters Home Care Agency
- Practice address
- 32 E Kingsbridge Rd
Suite 2E
Bronx, NY 10468-7513 - Phone
- (718) 584-6900
- Fax
- (718) 584-6901
- NPI assigned
- Jan 12, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Phillip Kwaku Duah
- Title
- Administrator
- Phone
- (718) 584-6900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1285L001 | NY | Primary |
Addresses
Primary practice location
32 E Kingsbridge Rd
Suite 2E
Bronx, NY 10468-7513
Mailing address
32 E Kingsbridge Rd
Suite 2E
Bronx, NY 10468-7513
Phone (718) 584-6900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02820482 | Medicaid | NY |
Other names 1
- Living Waters Home Care Agency
National Provider Directory
National Provider Directory- Tax ID family
- Blueline Home Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
32 E Kingsbridge Rd
Ste 2E
Bronx, NY 10468
Phone (718) 584-6900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1184775637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 E KINGSBRIDGE RD",
"address_2": "SUITE 2E",
"city": "BRONX",
"state": "NY",
"postal_code": "104687513",
"telephone_number": "718-584-6900",
"fax_number": "718-584-6901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 E KINGSBRIDGE RD",
"address_2": "SUITE 2E",
"city": "BRONX",
"state": "NY",
"postal_code": "104687513",
"telephone_number": "718-584-6900",
"fax_number": "718-584-6901"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OMEGA CARE SERVICES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-12",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "DUAH",
"authorized_official_first_name": "PHILLIP",
"authorized_official_middle_name": "KWAKU",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "718-584-6900"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NY",
"license": "1285L001",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02820482",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Living Waters Home Care Agency",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bronx, NY
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.