Organization
OMNI VISIONS, INC.
Active
Other names
Hackett 3 Home
Organization subpart
No
Provider details
NPI number
Authorized official
BRELYN WADDELL (CONTRACTS MANAGER)
(919) 334-0249
Entity
Organization
Contact information
Practice address
113 HACKETT ST, NORTH WILKESBORO, NC 28659-3266
(919) 334-0249
Mailing address
301 S PERIMETER PARK DR, STE 210, NASHVILLE, TN 37211-4143
(615) 726-3603
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408630
—
NC
Enumeration date
06/17/2013
Last updated
06/17/2013
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