# OPTIMIND MANAGED BEHAVIORAL HEALTHCARE ORGANIZATION CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OPTIMIND CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952718264
- **Authorized official:** MR. JORGE L PESQUERA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (787) 522-4618

## Contact information

- **Practice address:** CARR. \#3 KM. 13.4, BO. CANOVANILLAS, CAROLINA, PR 00984-0042
- **Practice address phone:** (787) 522-4618
- **Practice address fax:** (787) 522-4619
- **Mailing address:** PO BOX 20000, CANOVANAS, PR 00729-0042
- **Mailing address phone:** (787) 522-4618
- **Mailing address fax:** (787) 522-4619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | PAE013 | PR | Yes |

## Other

- **Enumeration date:** 07/18/2014
- **Last updated:** 07/18/2014