# OPTIMAL KIDS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1295376119
- **Authorized official:** MARY SHOUSE MS, OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (623) 628-7806

## Contact information

- **Practice address:** 2506 S 115TH LN, AVONDALE, AZ 85323-7637
- **Practice address phone:** (623) 628-7806
- **Mailing address:** 2506 S 115TH LN, AVONDALE, AZ 85323-7637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/02/2019
- **Last updated:** 10/02/2019