Provider Demographics
NPI:1003609546
Name:OPTIMAL BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:OPTIMAL BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DR. LAMECK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:NYAKWEBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-430-9646
Mailing Address - Street 1:11418 W ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-3421
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3523 45TH ST S STE 100
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8962
Practice Address - Country:US
Practice Address - Phone:602-430-9646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health