# OPTIMAL SENIOR LIVING, LLC

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

## Provider details

- **NPI number:** 1841028818
- **Authorized official:** NICOLE UNDERWOOD OTR (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (505) 750-0661

## Contact information

- **Practice address:** 4701 MORRIS ST NE APT 2702, ALBUQUERQUE, NM 87111-7736
- **Practice address phone:** (505) 750-0661
- **Practice address fax:** (505) 581-3286
- **Mailing address:** 11024 MONTGOMERY BLVD NE \# 101, ALBUQUERQUE, NM 87111-3962
- **Mailing address phone:** (505) 750-0661
- **Mailing address fax:** (505) 581-3286

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225XG0600X | Gerontology Occupational Therapist | — | NULL | Yes |
| 225XG0600X | Gerontology Occupational Therapist | — | — | Yes |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 07/22/2024
- **Last updated:** 07/24/2024