OMNI WEST ASSISTED LIVING RESIDENCE
NPI 1205049160
Assisted Living Facility in Youngstown, OH

Active since May 08, 2007CLIA Certified · 2 labs
3259 VESTAL RD, YOUNGSTOWN, OH 44509(330) 793-4404(330) 793-0630 Get Directions Write a Review

NPPES record last updated: June 18, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Assisted Living Facility
  • CLIA Number: 36D0342097
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-31-2026

About OMNI WEST ASSISTED LIVING RESIDENCE

This page provides the complete NPI Profile along with additional information for Omni West Assisted Living Residence, a provider established in Youngstown, Ohio operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1205049160 assigned on May 2007. The practitioner's primary taxonomy code is 310400000X with license number 2022R (OH). The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's other name is Omni West Assisted Living Residence. The authorized official of this NPI record is Mrs. Madeline Louise D'agostino Lpn (Director)

NPI
1205049160 Verify this NPI
Provider Legal Name
OMNI MANOR, INC.
Other Organization Name
OMNI WEST ASSISTED LIVING RESIDENCE
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
3259 VESTAL RD YOUNGSTOWN, OH 44509
Location Phone
(330) 793-4404
Location Fax
(330) 793-0630
Mailing Address
3259 VESTAL RD YOUNGSTOWN, OH 44509
Mailing Phone
(330) 793-4404
Mailing Fax
(330) 793-0630
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-08-2007
Last Update Date
06-18-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
2022R
License State
OH
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. MADELINE LOUISE D'AGOSTINO LPN

Authorized Official Title
DIRECTOR
Authorized Official Phone
(330) 793-4404

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
150284487MEDICAID (05)OH 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
36D0342097
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
THOMAS SEMPLE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Omni West Assisted Living Residence to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205049160, enumerated as an "organization" on May 08, 2007.

The provider is located at 3259 VESTAL RD YOUNGSTOWN, OH 44509 and the phone number is (330) 793-4404.

Assisted Living Facility with taxonomy code 310400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.