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Organization
OPTIMUM BEHAVIORAL SERVICES LLC
Active
Organization
OPTIMUM BEHAVIORAL SERVICES LLC
Active
Other names
home office
Organization subpart
No
Provider details
NPI number
Authorized official
MUTINTA CHESTNUT PMHNP (MEDICAL DIRECTOR)
(443) 557-8519
Entity
Organization
Contact information
Practice address
5020 ROUTE 9W STE 103, NEWBURGH, NY 12550-7901
(443) 557-8519
Mailing address
6340 SECURITY BLVD STE B-56, WOODLAWN, MD 21207-5173
(443) 557-8519
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/05/2023
Last updated
12/04/2023
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