Provider Demographics
NPI:1013619972
Name:OPTIMUM BEHAVIORAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:OPTIMUM BEHAVIORAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NIMO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI,
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-458-5083
Mailing Address - Street 1:7635 148TH ST W STE 236
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7800
Mailing Address - Country:US
Mailing Address - Phone:612-405-2154
Mailing Address - Fax:
Practice Address - Street 1:15322 GALAXIE AVE STE 203C
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-3152
Practice Address - Country:US
Practice Address - Phone:612-458-5083
Practice Address - Fax:612-354-8387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty