Optimus Behavioral Health LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

OPTIMUS BEHAVIORAL HEALTH LLC

Practice address

4600 E Washington St
Phoenix, AZ 85034-1903

Phone

(480) 840-4777

NPI assigned

Sep 25, 2021

Last updated

Dec 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Flora Issanda Stowater, PSYCH NP

Title

Administrator

Phone

(480) 840-4777

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1632528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1205507563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 E WASHINGTON ST STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850341908",
            "telephone_number": "480-840-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 E WASHINGTON ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850341903",
            "telephone_number": "480-840-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUS BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-25",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "STOWATER",
        "authorized_official_first_name": "FLORA",
        "authorized_official_middle_name": "ISSANDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-840-4777",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PSYCH NP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.