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Organization

OMEGA GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CORIE D JOHNSON (PARTNER / FOUNDER)
(443) 822-4357
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
06/26/2023
Last updated
06/26/2023
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