| Optimum Potential Community Services | |
|
120 Broadway Suite 306 Kissimmee FL 34741-5703 | |
| (407) 201-6577 | |
| Not Available |
| Full Name | Optimum Potential Community Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 120 Broadway, Kissimmee, Florida |
| Authorized Official Name and Position | Lucille Thomas (TARGETED CASE MANAGER) |
| Authorized Official Contact | 3213339197 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Potential Community Services 120 Broadway Ste 306 Kissimmee FL 34741-5706 Ph: (407) 201-6577 | Optimum Potential Community Services 120 Broadway Suite 306 Kissimmee FL 34741-5703 Ph: (407) 201-6577 |
| NPI Number | 1316317381 |
|---|---|
| Provider Enumeration Date | 10/02/2015 |
| Last Update Date | 06/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316317381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Florida) | Primary |
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