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Organization
OPTIMAL HEALTH MANAGEMENT
Active
Organization
OPTIMAL HEALTH MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA BRAKE LPC (CO-OWNER)
(541) 670-2264
Entity
Organization
Contact information
Practice address
753 SE MAIN ST, #204, 205, 212, ROSEBURG, OR 97470-3938
(541) 670-2264
(866) 298-7465
Mailing address
PO BOX 608, GLIDE, OR 97443-0608
(541) 670-2264
(866) 298-7465
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C3280
OR
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/28/2016
Last updated
09/28/2016
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