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General NPI Number Information
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NPI Number | 1518400936
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Entity Type | Organization
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Legal Business Name | OPTIMUM BEHAVIORAL SERVICES, LLC
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Dates
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Enumeration Date | 12/02/2016
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 7420 NW 5TH ST STE 110
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City | PLANTATION
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State | FL
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Zip | 33317-1611
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Country | US
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Telephone | 954-321-3595
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Fax | 954-321-3593
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Provider Business Mailing Address
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Address Line | 7420 NW 5TH ST STE 110
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City | PLANTATION
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State | FL
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Zip | 33317-1611
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Country | US
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Telephone | 954-321-3595
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Fax | 954-321-3593
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | BLANCA ROSA ONETTO
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Credential | BEHAVIOR ANALYST
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Telephone | 954-321-3595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 12165
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-11-8728
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License Number State | FL
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