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NPI Code Detail

MEDICARE: OLIVEBRANCH UNITY HEALTH SERVICES, LLC

MEDICARE: OLIVEBRANCH UNITY HEALTH SERVICES, LLC
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1730662842
Entity Type Code : Organization
Provider Name (Legal Business Name) : OLIVEBRANCH UNITY HEALTH SERVICES, LLC
Provider Business Mailing Address
First Line : 5245 CENTENNIAL BLVD STE 100
Second Line :
City : COLORADO SPGS
State : CO
Zip : 80919-4405
Country : US
Telephone Number : 719-354-4733
Fax Number : 719-374-5534
Provider Business Practice Location Address
First Line : 5245 CENTENNIAL BLVD STE 100
Second Line :
City : COLORADO SPGS
State : CO
Zip : 80919-4405
Country : US
Telephone Number : 719-354-4733
Fax Number : 719-374-5534
Authorized Official
Title or Position : CEO
Name : SHAQUINDRA D HALL
Credential : COTA/L
Telephone Number : 915-240-5618
Provider Enumeration Date : 09/13/2018
Last Update Date : 07/09/2021

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Directions to “OLIVEBRANCH UNITY HEALTH SERVICES, LLC ” Practice Location

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