Provider Demographics
NPI:1518400936
Name:OPTIMUM BEHAVIORAL SERVICES, LLC
Entity type:Organization
Organization Name:OPTIMUM BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:ROSA
Authorized Official - Last Name:ONETTO
Authorized Official - Suffix:
Authorized Official - Credentials:BEHAVIOR ANALYST
Authorized Official - Phone:954-321-3595
Mailing Address - Street 1:7420 NW 5TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1611
Mailing Address - Country:US
Mailing Address - Phone:954-321-3595
Mailing Address - Fax:954-321-3593
Practice Address - Street 1:7420 NW 5TH ST STE 110
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1611
Practice Address - Country:US
Practice Address - Phone:954-321-3595
Practice Address - Fax:954-321-3593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 12165101YM0800X
FL1-11-8728103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty