OM CRAFT LLC.


Address: 7 North Village Ave, Rockville Centre, NY 11570-4707
Phone: 5166196421

OM CRAFT LLC. (NPI# 1679908990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679908990
Entity Type Organization
Organization Name OM CRAFT LLC.
Other Organization Name REVOLUTION YOGA
Practice Address 7 North Village Ave
Rockville Centre
NY 11570-4707
Mailing Address 7 N Village Ave
Rockville Centre
NY 11570-4707
Practice Telephone 5166196421
Enumeration Date 2013-09-05
Last Update Date 2013-09-05
Authorized Official Name MS. AMANDA DIGIOVANNA (PRESIDENT, MANAGER, HEAD INSTRUCTOR)
Authorized Official Telephone 5166196421
Authorized Official Credential E-RYT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0400X Clinic/Center
Specialization: Rehabilitation
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Revolution Yoga Doing Business As Name - Organization

Office Location

Street Address 7 NORTH VILLAGE AVE
City ROCKVILLE CENTRE
State NY
Zip Code 11570-4707

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1427505858 Shera M Goodridge Specialist 134 Shellbank Place, Rockville Center, NY 11570 2016-09-01
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1265813703 Jeffrey Michael Nozius Registered Nurse 1000 Hempstead Ave, Rockville Centre, NY 11570 2015-06-10
1568855971 Meredith Kreinbihl Counselor 119 North Park Avenue, Suite 210, Rockville Centre, NY 11570 2015-03-09
1174921647 Pamela Leake Behavioral Analyst 88 Hendrickson Ave, Rvc, NY 11570 2014-12-15
1467851584 Lisa Brown-eisel, Lcsw, P.C. Social Worker 100 North Village Avenue, Suite 32, Rockville Centre, NY 11570 2014-08-14
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Taxonomy Information

Taxonomy Code 261QR0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation

Taxonomy Definition

Definition to come...

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Competitor

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City ROCKVILLE CENTRE
Zip Code 11570

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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