Provider Demographics
NPI:1457912289
Name:OPTIMAE REHABILITATION SERVICES LLC
Entity Type:Organization
Organization Name:OPTIMAE REHABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MAIZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-472-1684
Mailing Address - Street 1:301 W BURLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-3242
Mailing Address - Country:US
Mailing Address - Phone:641-472-1864
Mailing Address - Fax:
Practice Address - Street 1:600 E COURT AVE STE 200
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2058
Practice Address - Country:US
Practice Address - Phone:515-243-3525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMAE LIFESERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-24
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)