Organization
OPTIMUM BEHAVIORAL SERVICES LLC
Active
Other names
home office
Organization subpart
No
Provider details
NPI number
Authorized official
MUTINTA CHESTNUT PMHNP (MEDICAL DIRECTOR)
(443) 557-8519
Entity
Organization
Contact information
Practice address
5020 ROUTE 9W STE 103, NEWBURGH, NY 12550-7901
(443) 557-8519
Mailing address
6340 SECURITY BLVD STE B-56, WOODLAWN, MD 21207-5173
(443) 557-8519
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/05/2023
Last updated
12/04/2023
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