OMEHA HOUSE I LLC NPI 1083204507

NPI Information

  • NPI: 1083204507
  • Provider Name: OMEHA HOUSE I LLC
  • Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
  • Entity Type: Organization
  • Address: 500 NORTH ST
    HANNIBAL, MO
    ZIP 63401
  • Phone: (573) 221-9103

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NPI Details

OMEHA HOUSE I LLC is a residential treatment facility, intellectual and/or developmental disabilities in Hannibal, MO. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. OMEHA HOUSE I LLC NPI is 1083204507. The provider is registered as an organization entity type.

The provider's business location address is:

500 NORTH ST
HANNIBAL, MO
ZIP 63401-333
Phone: (573) 221-9103
Fax: (573) 406-1091

The provider's authorized official is Omar Delbert Ghattas .
The authorized official title is Owner and has the following contact phone number (573) 795-3614.

The enumeration date for this NPI number is 1/19/2021 and was last updated on 1/19/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1M267857308MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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