Provider Demographics
NPI:1942679295
Name:OPTIMUM HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:OPTIMUM HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:BOAFOA
Authorized Official - Last Name:MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-980-4754
Mailing Address - Street 1:50 PRINCETON HIGHTSTOWN RD STE 280
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-1107
Mailing Address - Country:US
Mailing Address - Phone:609-910-1105
Mailing Address - Fax:609-910-1106
Practice Address - Street 1:50 PRINCETON HIGHTSTOWN RD STE 280
Practice Address - Street 2:
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-1107
Practice Address - Country:US
Practice Address - Phone:609-910-1105
Practice Address - Fax:609-910-1106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0187800251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health