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Organization

OPTIMUM POTENTIAL COMMUNITY SERVICES LLC

Active
Parent organization
OPTIMUM POTENTIAL COMMUNITY SERVICES LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
OPTIMUM POTENTIAL COMMUNITY SERVICES LLC
Authorized official
LUCILLE THOMAS MS (CEO)
(321) 333-9197
Entity
Organization

Contact information

Practice address
120 BROADWAY STE 306, KISSIMMEE, FL 34741-5706
(407) 201-6577
(407) 350-3425
Mailing address
120 BROADWAY STE 306, KISSIMMEE, FL 34741-5706
(407) 201-6577
(407) 350-3425

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
08/25/2017
Last updated
07/21/2022
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