Provider Demographics
NPI:1295358844
Name:OPTIMUM HEALTH SYSTEMS, INC
Entity Type:Organization
Organization Name:OPTIMUM HEALTH SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR (OMHC)
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:OMOTOSHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-233-6200
Mailing Address - Street 1:2300 GARRISON BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-2308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 GARRISON BLVD STE 104
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-2308
Practice Address - Country:US
Practice Address - Phone:410-233-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management