MEDICARE: OLIVE BRANCH HEALTH SERV INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency	010083	TX
2	251E00000X	Home Health Agency	010083	TX

General Provider Information

NPI Number	:	1760558415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLIVE BRANCH HEALTH SERV INC

Provider Business Mailing Address
First Line	:	10998 S WILCREST DR STE 296
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-3596
Country	:	US
Telephone Number	:	281-575-7272
Fax Number	:	281-575-8847

Provider Business Practice Location Address
First Line	:	10998 S WILCREST DR STE 296
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-3596
Country	:	US
Telephone Number	:	281-575-7272
Fax Number	:	281-575-8847

Authorized Official
Title or Position	:	DON ADMINISTRATOR
Name	:	CHRISTIANA USEN
Credential	:
Telephone Number	:	281-575-7272

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	07/21/2022

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