Provider Demographics
NPI:1073339594
Name:OPTIMUM HEALTH
Entity type:Organization
Organization Name:OPTIMUM HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HUDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSHEEBLAWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-624-9090
Mailing Address - Street 1:5245 SCHAEFER RD STE B
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3257
Mailing Address - Country:US
Mailing Address - Phone:313-624-9090
Mailing Address - Fax:
Practice Address - Street 1:5245 SCHAEFER RD STE B
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3257
Practice Address - Country:US
Practice Address - Phone:313-624-9090
Practice Address - Fax:313-624-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-30
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy