Healthcare Provider Details

I. General information

NPI: 1891418083
Provider Name (Legal Business Name): OPTIMAL HOME CARE AGENCY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 SW GRIFFITH DR STE 272
BEAVERTON OR
97005-2977
US

IV. Provider business mailing address

2850 SW CEDAR HILLS BLVD # 142
BEAVERTON OR
97005-1354
US

V. Phone/Fax

Practice location:
  • Phone: 503-825-0600
  • Fax: 844-209-9719
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SUSAN MBUGUA
Title or Position: PRESIDENT
Credential:
Phone: 214-458-1713