OrganizationOmni House IncCommunity/Behavioral HealthAgenciesPractice Address1421 Madison Park Dr, Glen Burnie, MD 21061-5613(410) 768-6777PECOS EnrollmentBased on the most recent information from CMS, provider Omni House Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1942367222Provider TypeOrganizationFull NameOmni House IncSubpartNoEnumeration Date1/3/2007Last Updated8/22/2020Contact InformationPractice LocationPractice Address1421 Madison Park Dr, Glen Burnie, MD 21061-5613Phone(410) 768-6777FaxUnlisted FaxMailing LocationMailing AddressPO Box 1270, 1421 Madison Park Dr, Glen Burnie, MD 21060-1270Phone(410) 768-6777FaxUnlisted FaxAuthorized OfficialNameCuddy, John (Cfo)Phone(410) 768-6777Provider TaxonomiesCodeDescriptionLicenseCode251S00000XDescriptionCommunity/Behavioral HealthAgenciesLicense17445MarylandCode320800000XDescriptionCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment FacilitiesLicense17446Maryland