Organization
OPTIMAE LIFESERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY LYNN MCSTOCKARD (DIRECTOR OF BILLING)
(641) 472-1684
Entity
Organization
Contact information
Practice address
301 W BURLINGTON AVE, FAIRFIELD, IA 52556-3242
(641) 472-1684
(641) 472-4609
Mailing address
301 W BURLINGTON AVE, FAIRFIELD, IA 52556-3242
(641) 472-1684
(641) 472-4609
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0089052
—
IA
Enumeration date
10/11/2006
Last updated
02/25/2014
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