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Organization
OPTIMUM MENTAL HEALTH SERVICES, LLC
Active
Organization
OPTIMUM MENTAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LASCELLS MARTIN PHILLIPS LCSW (CEO)
(407) 703-3569
Entity
Organization
Contact information
Practice address
559 HIAWATHA PALM PL, APOPKA, FL 32712-3315
(407) 703-3569
Mailing address
559 HIAWATHA PALM PL, APOPKA, FL 32712-3315
(407) 703-3569
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW8417
FL
Other
Enumeration date
05/19/2011
Last updated
01/03/2013
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