| Optimal Health Management | |
|
753 Se Main St #204, 205, 212 Roseburg OR 97470-3938 | |
| (541) 670-2264 | |
| (866) 298-7465 |
| Full Name | Optimal Health Management |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 753 Se Main St, Roseburg, Oregon |
| Authorized Official Name and Position | Jessica Brake (CO-OWNER) |
| Authorized Official Contact | 5416702264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Health Management Po Box 608 Glide OR 97443-0608 Ph: (541) 670-2264 | Optimal Health Management 753 Se Main St #204, 205, 212 Roseburg OR 97470-3938 Ph: (541) 670-2264 |
| NPI Number | 1326597519 |
|---|---|
| Provider Enumeration Date | 09/28/2016 |
| Last Update Date | 09/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326597519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | C3280 (Oregon) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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