Healthcare Provider Details

I. General information

NPI: 1649885674
Provider Name (Legal Business Name): OPTIMAL HOME HEALTH & LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1444 E SHELBY DR STE 203
MEMPHIS TN
38116-7244
US

IV. Provider business mailing address

1444 E SHELBY DR STE 203
MEMPHIS TN
38116-7244
US

V. Phone/Fax

Practice location:
  • Phone: 901-207-2275
  • 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

VIII. Authorized Official

Name: VALENCIA BAYMON
Title or Position: COO
Credential:
Phone: 901-833-5592