Provider Demographics
NPI:1497169312
Name:OPTIMAL OUTCOMES, LLC
Entity Type:Organization
Organization Name:OPTIMAL OUTCOMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:II
Authorized Official - Credentials:MS
Authorized Official - Phone:916-390-8884
Mailing Address - Street 1:600 W 107TH ST
Mailing Address - Street 2:#106
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-5927
Mailing Address - Country:US
Mailing Address - Phone:916-390-8884
Mailing Address - Fax:913-730-8375
Practice Address - Street 1:600 W 107TH ST
Practice Address - Street 2:#106
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5927
Practice Address - Country:US
Practice Address - Phone:916-390-8884
Practice Address - Fax:913-730-8375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011009478103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty