Provider Demographics
NPI:1467075424
Name:OPTIMISM HOME HEALTH CARE SERVICES, LLC
Entity Type:Organization
Organization Name:OPTIMISM HOME HEALTH CARE SERVICES, LLC
Other - Org Name:OPTIMISM HOME CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WEST
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:757-440-3365
Mailing Address - Street 1:1403 AIR RAIL AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-3001
Mailing Address - Country:US
Mailing Address - Phone:757-440-3415
Mailing Address - Fax:
Practice Address - Street 1:1403 AIR RAIL AVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-3001
Practice Address - Country:US
Practice Address - Phone:757-440-3415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAMCO-202338Medicaid