Optimum Home Care Services, LLC

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Legal business name

OPTIMUM HOME CARE SERVICES, LLC

Practice address

4800 White Oak TRL
Stone Mountain, GA 30088-3007

Phone

(678) 863-2738

Fax

(470) 282-0031

NPI assigned

Aug 11, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ally Emanuel Mdamu

Title

Owner

Phone

(678) 863-2738

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1144903410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 WHITE OAK TRL",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300883007",
            "telephone_number": "678-863-2738",
            "fax_number": "470-282-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 WHITE OAK TRL",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300883007",
            "telephone_number": "678-863-2738",
            "fax_number": "470-282-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM HOME CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-11",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "MDAMU",
        "authorized_official_first_name": "ALLY",
        "authorized_official_middle_name": "EMANUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-863-2738"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.