Organization
OPTIMUM POTENTIAL COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LUCILLE THOMAS MS (TARGETED CASE MANAGER)
(321) 333-9197
Entity
Organization
Contact information
Practice address
120 BROADWAY, SUITE 306, KISSIMMEE, FL 34741-5703
(407) 201-6577
Mailing address
120 BROADWAY STE 306, KISSIMMEE, FL 34741-5706
(407) 201-6577
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
FL
Other
Enumeration date
10/02/2015
Last updated
06/17/2016
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