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General NPI Number Information
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NPI Number | 1568624583
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Entity Type | Organization
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Legal Business Name | OPTIMAL HEALTHCARE L.L.C.
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 26 SAYBROOK RD UNIT A
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City | MIDDLETOWN
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State | CT
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Zip | 06457-4703
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Country | US
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Telephone | 860-788-2089
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Fax |
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Provider Business Mailing Address
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Address Line | 26 SAYBROOK RD UNIT A
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City | MIDDLETOWN
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State | CT
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Zip | 06457-4703
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Country | US
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Telephone | 860-788-2089
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Fax |
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Authorized Official
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Title or Position | C.E.O.
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Name | JACQUELINE E WHITE
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Credential |
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Telephone | 860-788-2089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCA0000309
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License Number State | CT
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