# OMEGA GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174209860
- **Authorized official:** DR. CORIE D JOHNSON (PARTNER / FOUNDER)
- **Authorized official phone:** (443) 822-4357

## Contact information

- **Practice address:** 301 S MCDOWELL ST STE 125, CHARLOTTE, NC 28204-0031
- **Practice address phone:** (443) 822-4357
- **Mailing address:** 301 S MCDOWELL ST STE 125, CHARLOTTE, NC 28204-0031
- **Mailing address phone:** (443) 822-4357

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 06/26/2023
- **Last updated:** 06/26/2023