Provider Demographics
NPI:1669842217
Name:OPTIMUM HOME HEALTH CARE
Entity Type:Organization
Organization Name:OPTIMUM HOME HEALTH CARE
Other - Org Name:OPTIMUM HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-704-9031
Mailing Address - Street 1:7607 W TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-3974
Mailing Address - Country:US
Mailing Address - Phone:414-704-9031
Mailing Address - Fax:
Practice Address - Street 1:7607 W TOWNSEND ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-3974
Practice Address - Country:US
Practice Address - Phone:414-704-9031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care