Provider Demographics
NPI:1902108194
Name:OPTIMAL FAMILY HEALTH CARE
Entity Type:Organization
Organization Name:OPTIMAL FAMILY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FATMATA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-220-1762
Mailing Address - Street 1:7221 HANOVER PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2022
Mailing Address - Country:US
Mailing Address - Phone:301-220-1762
Mailing Address - Fax:301-220-1764
Practice Address - Street 1:7221 HANOVER PKWY STE D
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2022
Practice Address - Country:US
Practice Address - Phone:301-220-1762
Practice Address - Fax:301-220-1764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2954P251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health