Organization
OMEGA SUPPORTED LIVING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE SMITH (CEO)
(228) 217-6329
Entity
Organization
Contact information
Practice address
404 WESTWOOD ST, MOBILE, AL 36606-6504
(228) 217-6329
Mailing address
404 WESTWOOD ST, MOBILE, AL 36606-6504
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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