Provider Demographics
NPI:1659763308
Name:OPTIMAL HOMECARE SERVICES LLC
Entity Type:Organization
Organization Name:OPTIMAL HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NEMATA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7036-592-1700
Mailing Address - Street 1:5524 HEMPSTEAD WAY STE B
Mailing Address - Street 2:ROOM 204
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-4009
Mailing Address - Country:US
Mailing Address - Phone:703-659-2170
Mailing Address - Fax:703-348-2016
Practice Address - Street 1:5524 HEMPSTEAD WAY STE B
Practice Address - Street 2:ROOM 204
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-4009
Practice Address - Country:US
Practice Address - Phone:703-659-2170
Practice Address - Fax:703-348-2016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health