Provider Demographics
NPI:1093604787
Name:OPTIMUM BEHAVIORAL HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:OPTIMUM BEHAVIORAL HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:WILLILAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-465-5821
Mailing Address - Street 1:PO BOX 135
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71294-0135
Mailing Address - Country:US
Mailing Address - Phone:318-465-5821
Mailing Address - Fax:
Practice Address - Street 1:116 VERSAILLES BLVD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-4009
Practice Address - Country:US
Practice Address - Phone:318-465-5821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty