Provider Demographics
NPI:1548738040
Name:OPTIMACARE HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:OPTIMACARE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCHELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUTE MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-693-7953
Mailing Address - Street 1:930 STUYVESANT AVE STE 2A
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6964
Mailing Address - Country:US
Mailing Address - Phone:908-623-3025
Mailing Address - Fax:
Practice Address - Street 1:930 STUYVESANT AVE STE 2A
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6964
Practice Address - Country:US
Practice Address - Phone:908-623-3025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health