Organization
CDP, LLC
Active
Other names
Omni Home Care, Omni Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWAYNE T GOFF (OWNER)
(985) 674-5175
Entity
Organization
Contact information
Practice address
68445 TAMMANY TRACE DR, MANDEVILLE, LA 70471-7779
(985) 647-5175
(985) 674-5177
Mailing address
68445 TAMMANY TRACE DR, MANDEVILLE, LA 70471-7779
(985) 647-5175
(985) 674-5177
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1013
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1400971
—
LA
Enumeration date
11/27/2006
Last updated
06/06/2023
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