| Organization Name: | OPTIMUM MENTAL HEALTH SERVICES, LLC |
| NPI Number: | 1194018424 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LASCELLS MARTIN PHILLIPS (CEO) |
| Mailing Address: | 559 Hiawatha Palm Pl Apopka |
| State: | FL US |
| Postal Code: | 327123315 |
| Phone Number: | 4077033569 |
| Fax Number: | |
| NPI Enumeration Date: | 05/19/2011 |
| NPI Last Update Date: | 01/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW8417 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |