Provider Demographics
NPI:1851628846
Name:OPTIMA CARE HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:OPTIMA CARE HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT - CEO / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON ALAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:DE LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-626-8020
Mailing Address - Street 1:3595-4 INLAND EMPIRE BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-7978
Mailing Address - Country:US
Mailing Address - Phone:866-626-8020
Mailing Address - Fax:909-980-0004
Practice Address - Street 1:3595-4 INLAND EMPIRE BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-7978
Practice Address - Country:US
Practice Address - Phone:866-626-8020
Practice Address - Fax:909-980-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000785251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059099OtherMEDICARE