Provider Demographics
NPI:1700475415
Name:OPTIMUM PSYCHIATRIC HEALTH, PLLC
Entity Type:Organization
Organization Name:OPTIMUM PSYCHIATRIC HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIVOAMORE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:978-233-1594
Mailing Address - Street 1:142 LOWELL RD
Mailing Address - Street 2:UNIT 17-151
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-4938
Mailing Address - Country:US
Mailing Address - Phone:978-233-1594
Mailing Address - Fax:877-247-8587
Practice Address - Street 1:142 LOWELL RD UNIT 17-151
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4938
Practice Address - Country:US
Practice Address - Phone:978-233-1594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-16
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty