| Optimal Neuroscience Services Llc | |
|
2775 Village Pt Chesterton IN 46304-0099 | |
| (219) 304-6700 | |
| Not Available |
| Full Name | Optimal Neuroscience Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2775 Village Pt, Chesterton, Indiana |
| Authorized Official Name and Position | Regina Nelson (CEO) |
| Authorized Official Contact | 7083698022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Neuroscience Services Llc 3147 W 65th Ave Merrillville IN 46410-2978 Ph: () - | Optimal Neuroscience Services Llc 2775 Village Pt Chesterton IN 46304-0099 Ph: (219) 304-6700 |
| NPI Number | 1174006704 |
|---|---|
| Provider Enumeration Date | 09/10/2018 |
| Last Update Date | 09/10/2018 |
| Medicare PECOS PAC ID | 6901159060 |
|---|---|
| Medicare Enrollment ID | O20181019001634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174006704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Regina Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679966030 PECOS PAC ID: 9830400811 Enrollment ID: I20150930001099 |
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