NPI Code Details Logo

NPI 1184725491

NPI 1184725491 : OLIVE CREST : SANTA ANA, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1184725491
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    OLIVE CREST 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/26/2006
-----------------------------------------------------
    Last Update Date     |    10/29/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2130 E 4TH ST SUITE 200
-----------------------------------------------------
    City                 |    SANTA ANA
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    92705-3818
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    714-543-5437
-----------------------------------------------------
    Fax                  |    714-543-5463
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2130 E 4TH ST STE 200 
-----------------------------------------------------
    City                 |    SANTA ANA
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    92705-3818
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    714-543-5437
-----------------------------------------------------
    Fax                  |    714-543-5463
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
    Name                 |    MR. DONALD A VERLEUR II
-----------------------------------------------------
    Credential           |    MBA
-----------------------------------------------------
    Telephone            |    714-543-5437
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251S00000X
-----------------------------------------------------
    Taxonomy Name        |    Community/Behavioral Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.