Organization
KP OPTIMUM CARE BEHAVIORAL SERVICES
Active
Other names
KP Optimum Care
Organization subpart
No
Provider details
NPI number
Authorized official
KATUMU FRANCES PETTIQUOI LCPC (CEO)
(301) 641-2284
Entity
Organization
Contact information
Practice address
370 MAIN ST, LAUREL, MD 20707-4133
(301) 641-2284
Mailing address
PO BOX 114, LAUREL, MD 20725-0114
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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