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General NPI Number Information
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NPI Number | 1790375046
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Entity Type | Organization
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Legal Business Name | OPTIMUM HOME HEALTH SERVICES
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 121 WAY POINTE RIDGE AVE
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City | LITTLE RIVER
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State | SC
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Zip | 29566-7744
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Country | US
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Telephone | 910-734-3818
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Fax |
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Provider Business Mailing Address
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Address Line | 121 WAY POINTE RIDGE AVE
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City | LITTLE RIVER
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State | SC
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Zip | 29566-7744
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Country | US
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Telephone | 910-734-3818
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. APRIL CHAVIS
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Credential | LPC
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Telephone | 910-734-3818
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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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