Organization
OMNI VISIONS, INC
Active
Organization
OMNI VISIONS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRELYN WADDELL (AR MANAGER)
(919) 334-0249
Entity
Organization
Contact information
Practice address
910 C ST, SUITE 8, NORTH WILKESBORO, NC 28659-4145
(336) 838-2412
(336) 667-5773
Mailing address
301 S PERIMETER PARK DR, SUITE 210, NASHVILLE, TN 37211-4143
(615) 726-3603
(615) 726-3632
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
50053
KY
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
NA
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
SO 09985A
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301141
—
NC
05
—
8301141B
—
NC
05
—
8301141G
—
NC
05
—
8301141H
—
NC
05
—
8301141I
—
NC
Enumeration date
11/30/2006
Last updated
03/19/2012
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