Provider Demographics
NPI:1013775063
Name:OPTIMAL CARE PSYCHIATRY
Entity Type:Organization
Organization Name:OPTIMAL CARE PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YETUNDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLOTO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:240-714-9488
Mailing Address - Street 1:7310 RITCHIE HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3065
Mailing Address - Country:US
Mailing Address - Phone:240-728-7544
Mailing Address - Fax:240-593-5691
Practice Address - Street 1:7310 RITCHIE HWY STE 200
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3065
Practice Address - Country:US
Practice Address - Phone:240-728-7544
Practice Address - Fax:240-593-5691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty