Provider Demographics
NPI:1144593229
Name:OPTIMAL HOME CARE, LLC
Entity type:Organization
Organization Name:OPTIMAL HOME CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIERKS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:602-466-7570
Mailing Address - Street 1:15282 W BROOKSIDE LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15282 W BROOKSIDE LN
Practice Address - Street 2:SUITE 110
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2447
Practice Address - Country:US
Practice Address - Phone:602-466-7570
Practice Address - Fax:602-466-7507
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFFINITY HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care