Healthcare Provider Details

I. General information

NPI: 1427532316
Provider Name (Legal Business Name): OPTIMAL HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SISTER PIERRE DR STE 207
TOWSON MD
21204-7525
US

IV. Provider business mailing address

120 SISTER PIERRE DR STE 207
BALTIMORE MD
21204-7525
US

V. Phone/Fax

Practice location:
  • Phone: 443-939-6585
  • Fax: 443-841-7680
Mailing address:
  • Phone: 443-939-6585
  • Fax: 443-841-7680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: VICTORIA MOJIBOLA
Title or Position: CEO
Credential: DNP, CRNP-PMH
Phone: 443-939-6585