Organization
OMNI COMMUNITY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK JUST (CHIEF EXECUTIVE OFFICER)
(615) 726-3603
Entity
Organization
Contact information
Practice address
665 SOUTH JEFFERSON AVE, COOKEVILLE, TN 38501-4011
(931) 528-0051
(931) 582-0021
Mailing address
301 S. PERIMETER PARK DRIVE, SUITE 210, NASHVILLE, TN 37211-4128
(615) 726-3603
(615) 827-0421
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
L 214-017-3653
TN
103T00000X
Psychologist
L 214-017-3653
TN
104100000X
Social Worker
L 214-017-3653
TN
106H00000X
Marriage & Family Therapist
L 214-017-3653
TN
163WC1500X
Community Health Registered Nurse
L 214-017-3653
TN
163WP0808X
Psychiatric/Mental Health Registered Nurse
L 214-017-3653
TN
164W00000X
Licensed Practical Nurse
L 214-017-3653
TN
2084P0800X
Psychiatry Physician
L 214-017-3653
TN
251B00000X
Case Management Agency
L214-017-3653
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
L 214-017-3653
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3376955
—
TN
05
—
Q019886
—
TN
Enumeration date
01/09/2007
Last updated
09/02/2020
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