MEDICARE: OLIVE ANGEL CARE SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	251E00000X	Home Health Agency
3	251G00000X	Community Based Hospice Care Agency
4	101YM0800X	Mental Health Counselor
5	310400000X	Assisted Living Facility
6	3104A0625X	Assisted Living Facility (Mental Illness)
7	253Z00000X	In Home Supportive Care Agency
8	261QA0600X	Adult Day Care Clinic/Center
9	261QD1600X	Developmental Disabilities Clinic/Center
10	261QR0800X	Recovery Care Clinic/Center
11	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
12	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
13	364SL0600X	Long-Term Care Clinical Nurse Specialist

General Provider Information

NPI Number	:	1235085382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLIVE ANGEL CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	6237 HIGHWAY 6 S
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-1680
Country	:	US
Telephone Number	:	832-757-3060
Fax Number	:

Provider Business Practice Location Address
First Line	:	6237 HIGHWAY 6 S
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-1680
Country	:	US
Telephone Number	:	832-757-3060
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DEBORAH YISA
Credential	:
Telephone Number	:	832-757-3060

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “OLIVE ANGEL CARE SERVICES LLC ” Practice Location

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