MEDICARE: OLIVE HOME HEALTH CARE

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	253Z00000X	In Home Supportive Care Agency	011312	TX
2	251E00000X	Home Health Agency	011312	TX

General Provider Information

NPI Number	:	1396038253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLIVE HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	12431 NEWBROOK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-3911
Country	:	US
Telephone Number	:	281-564-5764
Fax Number	:	281-564-5764

Provider Business Practice Location Address
First Line	:	12431 NEWBROOK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-3911
Country	:	US
Telephone Number	:	281-564-5764
Fax Number	:	281-564-5764

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MS. OLUKEMI OLASUMBO
Credential	:	RN
Telephone Number	:	713-560-5608

Provider Enumeration Date	:	05/25/2011
Last Update Date	:	05/25/2011

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Directions to “OLIVE HOME HEALTH CARE ” Practice Location

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