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General NPI Number Information
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NPI Number | 1003449893
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Entity Type | Organization
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Legal Business Name | OPTIMAL HEALTH HOME CARE LLC
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 2140 HIGHWAY 157 N
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City | MANSFIELD
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State | TX
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Zip | 76063-4847
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Country | US
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Telephone | 817-813-8055
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Fax | 817-753-0100
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Provider Business Mailing Address
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Address Line | 2140 HIGHWAY 157 N
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City | MANSFIELD
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State | TX
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Zip | 76063-4847
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Country | US
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Telephone | 817-813-8055
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Fax | 817-753-0100
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Authorized Official
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Title or Position | OWNER
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Name | LISELOTTE ADDEA-AMOAKO
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Credential | APRN
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Telephone | 817-779-4805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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