Organization
OMNIS HEALTH LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RACHEL WILSON (CHAIRWOMAN)
(678) 561-3037
Entity
Organization
Contact information
Practice address
2200 GARRISON BLVD STE 100 200 300, BALTIMORE, MD 21216-2619
(667) 212-4187
Mailing address
162 PONTE VEDRA DR, FAYETTEVILLE, GA 30215-8040
(678) 561-2823
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
—
—
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
03/03/2017
Last updated
09/02/2025
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