Optimum Potential Community Services LLC

Primary specialty

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

Legal business name

OPTIMUM POTENTIAL COMMUNITY SERVICES LLC

Practice address

120 Broadway Ste 306
Kissimmee, FL 34741-5706

Phone

(407) 201-6577

Fax

(407) 350-3425

NPI assigned

Aug 25, 2017

Organization subpart

Yes

Parent organization

OPTIMUM POTENTIAL COMMUNITY SERVICES LLCAs reported in NPPES

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

Authorized official

Name

Lucille Thomas, MSNPI 1780983627

Title

Ceo

Phone

(321) 333-9197

Specialties & licenses 2

Addresses

Tax ID family

Optimum Potential Community Services LLC2 organizations share this tax ID, including this one

Part of

Optimum Potential Community Services LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Optimum Potential Community Services

  • Community/Behavioral Health Agency
  • Kissimmee, FL
  • NPI 1316317381
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Optimum Potential Community Services

  • Community/Behavioral Health Agency
  • Kissimmee, FL
  • NPI 1316317381
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lucille Thomas

  • Case Manager/Care Coordinator
  • Kissimmee, FL
  • NPI 1780983627
  NPD Authorized official
• Jasmine Martin, MA, RMFTI

  • Marriage & Family Therapist
  • Saint Cloud, FL
  • NPI 1801331558
  NPD (past)

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1306363783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BROADWAY STE 306",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415706",
            "telephone_number": "407-201-6577",
            "fax_number": "407-350-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BROADWAY STE 306",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415706",
            "telephone_number": "407-201-6577",
            "fax_number": "407-350-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM POTENTIAL COMMUNITY SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OPTIMUM POTENTIAL COMMUNITY SERVICES LLC",
        "enumeration_date": "2017-08-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "LUCILLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-333-9197",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nancy Oquendo-Rolon, MSW
• Betty Oquendo, B.S.
• Orabiologics LLC
• Oral and Facial Surgery Center

• Mental Health Clinic/Center (Including Community Mental Health Center) in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.