Organization
OMNI COMMUNITY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK JUST (CHIEF EXECUTIVE OFFICER)
(615) 726-3603
Entity
Organization
Contact information
Practice address
103 WEAKLEY CREEK ROAD, SUITE B, LAWRENCEBURG, TN 38464-2237
(931) 766-1916
(931) 766-4016
Mailing address
301 S PERIMETER PARK DRIVE, SUITE 210, NASHVILLE, TN 37211-4128
(615) 726-3603
(615) 827-0421
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3376955
GROUP MEDICARE
TN
05
—
Q019917
—
TN
Enumeration date
11/06/2008
Last updated
09/04/2020
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