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General NPI Number Information
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NPI Number | 1598409088
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Entity Type | Organization
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Legal Business Name | OPTIMAL LIVING HOME CARE SERVICES
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 615 SAINT GEORGE SQUARE CT STE 316
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City | WINSTON SALEM
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State | NC
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Zip | 27103-1368
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Country | US
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Telephone | 336-778-3316
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Fax |
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Provider Business Mailing Address
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Address Line | 615 SAINT GEORGE SQUARE CT STE 300
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City | WINSTON SALEM
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State | NC
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Zip | 27103-1368
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Country | US
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Telephone | 336-778-3316
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Fax | 336-778-3301
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | MS. JANNEH JOYOUS PETERS
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Credential |
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Telephone | 336-997-2898
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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 |
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License Number State |
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