Organization
OMADA, INC.
Active
Other names
Omada Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN B GREEN CPA (BUSINESS MANAGER)
(507) 664-9407
Entity
Organization
Contact information
Practice address
401 DIVISION ST S, SUITE A, NORTHFIELD, MN 55057-2095
(507) 664-9407
(507) 664-3862
Mailing address
401 DIVISION ST S, SUITE A, NORTHFIELD, MN 55057-2095
(507) 664-9407
(507) 664-3862
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1023523-2-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032951
PREFERRED ONE
—
01
—
124611
MMSI
—
01
—
173158
UCARE
—
01
—
2H51OM
BCBS
—
01
—
5045989
MEDICA/UBH
—
01
—
91167
HEALTHPARTNERS
—
Enumeration date
06/18/2006
Last updated
08/22/2020
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