Organization
OPTIMAE LIFESERVICES, INC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY LYNN MCSTOCKARD (DIRECTOR OF BILLING)
(641) 472-1684
Entity
Organization
Contact information
Practice address
301 W BURLINGTON AVE, FAIRFIELD, IA 52556-3242
(641) 472-5771
(641) 472-1817
Mailing address
301 W BURLINGTON AVE, FAIRFIELD, IA 52556-3242
(641) 472-1684
(641) 472-4609
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
03816
IA
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0272021
—
IA
01
—
58181
BCBS
IA
Enumeration date
07/07/2005
Last updated
07/29/2013
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