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General NPI Number Information
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NPI Number | 1942118443
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Entity Type | Organization
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Legal Business Name | OLIVE BRANCH RANCH FOUNDATION
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 164 GRACE CT
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City | LEMOORE
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State | CA
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Zip | 93245-2881
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Country | US
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Telephone | 559-633-6039
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Fax | 559-633-6039
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Provider Business Mailing Address
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Address Line | 164 GRACE CT
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City | LEMOORE
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State | CA
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Zip | 93245-2881
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Country | US
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Telephone | 559-633-6039
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Fax | 559-633-6039
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Authorized Official
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Title or Position | PRESIDENT & CO-FOUNDER
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Name | HEATHER M MALLARD
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Credential | MALLARD
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Telephone | 559-633-6039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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