Organization
OPTIMUM HEALTH FOUNDATION
Active
Other names
Optimum Health Group
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LONG (ED)
(202) 455-2030
Entity
Organization
Contact information
Practice address
1800 EVARTS ST NE, 1800 EVARTS STREET NE, WASHINGTON, DC 20018-1311
(202) 455-2030
Mailing address
1800 EVARTS ST NE, 1800 EVARTS STREET NE, WASHINGTON, DC 20018-1311
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
163W00000X
Registered Nurse
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/24/2011
Last updated
01/24/2011
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