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General NPI Number Information
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NPI Number | 1871478271
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Entity Type | Organization
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Legal Business Name | OLIVE CREST
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 4285 N RANCHO DR STE 160
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City | LAS VEGAS
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State | NV
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Zip | 89130-3456
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Country | US
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Telephone | 702-835-1933
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Fax |
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Provider Business Mailing Address
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Address Line | 2130 E 4TH ST STE 200
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City | SANTA ANA
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State | CA
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Zip | 92705-3818
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Country | US
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Telephone | 714-543-5437
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DONALD VERLEUR
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Credential | MBA
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Telephone | 714-543-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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