| Optimum Behavioral Health, Inc. | |
|
5384 Poplar Ave Suite 313 Memphis TN 38119-3609 | |
| (901) 237-0261 | |
| (901) 683-2058 |
| Full Name | Optimum Behavioral Health, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 5384 Poplar Ave, Memphis, Tennessee |
| Authorized Official Name and Position | W Edward Amos (OWNER) |
| Authorized Official Contact | 9012370261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Behavioral Health, Inc. 5384 Poplar Ave Suite 313 Memphis TN 38119-3609 Ph: (901) 237-0261 | Optimum Behavioral Health, Inc. 5384 Poplar Ave Suite 313 Memphis TN 38119-3609 Ph: (901) 237-0261 |
| NPI Number | 1689655268 |
|---|---|
| Provider Enumeration Date | 11/09/2005 |
| Last Update Date | 08/27/2014 |
| Medicare PECOS PAC ID | 9537131818 |
|---|---|
| Medicare Enrollment ID | O20040807000189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689655268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Wilmer E Amos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134100712 PECOS PAC ID: 1658344601 Enrollment ID: I20111206000170 |
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