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OMEGA LONG TERM CARE LLC
NPI 1285042184
Assisted Living Facility in Bridgeton, MO

Active since July 24, 2014
12800 BOENKER LN, BRIDGETON, MO 63044(314) 551-0338(314) 551-0336 Get Directions Write a Review

NPPES record last updated: July 24, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Omega Long Term Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OMEGA LONG TERM CARE LLC (NPI 1285042184) is a healthcare organization registered as an assisted living facility in Bridgeton, Missouri and active in the NPI registry since July 2014. The organization lists Kim L Wyatt, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1285042184
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameOMEGA LONG TERM CARE LLC
Location Address12800 BOENKER LNBridgeton, MO 63044-2438
Mailing Address12800 Boenker LnBridgeton, MO 63044-2438 · (314) 551-0338 · Fax (314) 551-0336
Phone(314) 551-0338
Fax(314) 551-0336
Organization SubpartNo
Authorized OfficialKim L WyattOffice Manager · (314) 808-5083
Enumeration DateJuly 24, 2014
✔ NPI 1285042184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MO · 137743
Definition
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.
12800 BOENKER LN, Bridgeton, MO 63044
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Other Identifiers 4

Medicaid429398209MO
Medicaid207937715MO
Medicaid2001189801MO
Medicaid2083138069MO

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHYLICIA LITTLE FNP-BC
Nurse Practitioner (Family)
12800 BOENKER LN
BRIDGETON, MO 63044
St. Louis County (314) 499-6060
AIREAL SHASAUNDAI BISHOP NP
Nurse Practitioner (Gerontology)
12800 BOENKER LN
BRIDGETON, MO 63044
St. Louis County (314) 467-8506
BRIDGETON GERIATRICS LLC
Family Medicine
12800 BOENKER LN
BRIDGETON, MO 63044
St. Louis County (314) 551-0338
YAM HOME HEALTH LLC
Home Health
12800 BOENKER LN
BRIDGETON, MO 63044
St. Louis County (314) 467-8506
YAM MEDICAL CENTER LLC
General Practice
12800 BOENKER LN
BRIDGETON, MO 63044
St. Louis County (314) 499-6060
ANDREA E IVY N.P.
Nurse Practitioner (Family)
12800 BOENKER LN
BRIDGETON, MO 63044
St. Louis County (314) 551-0338
DOCTORS GROUP , PC
Internal Medicine
12800 BOENKER LN
BRIDGETON, MO 63044
St. Louis County (314) 551-0338
DR. KHALED R HASSAN MD
Internal Medicine
12800 BOENKER LN
BRIDGETON, MO 63044
St. Louis County (314) 551-0338

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Omega Long Term Care LLC's NPI number?

The NPI number for Omega Long Term Care LLC is 1285042184. It was assigned to this organization in the NPPES registry on July 24, 2014.

Where is Omega Long Term Care LLC located?

Omega Long Term Care LLC is located at 12800 Boenker Ln, Bridgeton, MO 63044. The listed phone number is (314) 551-0338.

What is Omega Long Term Care LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Omega Long Term Care LLC was last updated on July 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.