Healthcare Provider Details

I. General information

NPI: 1811451693
Provider Name (Legal Business Name): OPTIMUM GUIDANCE BEHAVIOR CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2019
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 E SOUTH BOULDER RD STE O
LOUISVILLE CO
80027-2548
US

IV. Provider business mailing address

2 ADAMS ST APT 1406
DENVER CO
80206-5727
US

V. Phone/Fax

Practice location:
  • Phone: 720-771-0852
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARRIE MYERS
Title or Position: DIRECTOR
Credential:
Phone: 541-761-6230