# OMNI BEHAVIORAL SERVICES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Omni Behavioral Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083257562
- **Authorized official:** JOHN A JACKSON (SENIOR ADMINISTRATOR)
- **Authorized official phone:** (910) 247-6822

## Contact information

- **Practice address:** 209 MARTIN LUTHER KING JR. DR., ELIZABETHTOWN, NC 28337-2833
- **Practice address phone:** (910) 247-6822
- **Practice address fax:** (910) 247-6829
- **Mailing address:** 209 MARTIN LUTHER KING JR. DR., ELIZABETHTOWN, NC 28352
- **Mailing address phone:** (910) 247-6822
- **Mailing address fax:** (910) 247-6829

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 10/28/2019
- **Last updated:** 10/28/2019