Provider Demographics
NPI:1467966010
Name:OPTIMAL HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:OPTIMAL HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CNO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHIDI
Authorized Official - Middle Name:DALLAS
Authorized Official - Last Name:IHEZUE
Authorized Official - Suffix:SR
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:703-582-5708
Mailing Address - Street 1:2865 POWELL DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6061
Mailing Address - Country:US
Mailing Address - Phone:703-582-5708
Mailing Address - Fax:
Practice Address - Street 1:2865 POWELL DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-6061
Practice Address - Country:US
Practice Address - Phone:703-582-5708
Practice Address - Fax:703-582-5708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health