# OPTIMAL MENTAL OUTLOOK

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104660067
- **Authorized official:** JASMINE GRAVES PMHNP-BC (OWNER)
- **Authorized official phone:** (317) 496-8036

## Contact information

- **Practice address:** 5945 NEWBERRY PINES AVE, WESLEY CHAPEL, FL 33545-5294
- **Practice address phone:** (317) 496-8036
- **Mailing address:** 5945 NEWBERRY PINES AVE, WESLEY CHAPEL, FL 33545-5294
- **Mailing address phone:** (317) 496-8036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 3104A0625X | Assisted Living Facility (Mental Illness) | — | NULL | — |
| 3104A0630X | Assisted Living Facility (Behavioral Disturbances) | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/24/2024
- **Last updated:** 06/24/2024