Omega Supported Living Services

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

OMEGA SUPPORTED LIVING SERVICES

Practice address

404 Westwood St
Mobile, AL 36606-6504

Phone

(228) 217-6329

NPI assigned

Dec 21, 2011

Organization subpart

No

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

Authorized official

Name

Leslie Smith

Title

Ceo

Phone

(228) 217-6329

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1851660781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 WESTWOOD ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366066504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 WESTWOOD ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366066504",
            "telephone_number": "228-217-6329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA SUPPORTED LIVING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "228-217-6329"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Wilkins Olzinski, LCSW
• Bassam A. Omar, MD
• Mariam Husam Omar
• Nidal Bassam Omar
• Omega Adult Day Care
• Allison Omohundro
• Erica Onagbola, PHARM D
• One Source of the Gulf Coast Inc.
• Onecall Telemed
• Ophir Global LLC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Mobile, AL
• Providers in Mobile, AL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.