# OLIVERA HEALTH GROUP IA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255192423
- **Authorized official:** MENACHEM HOFFMAN (OWNER)
- **Authorized official phone:** (917) 345-9464

## Contact information

- **Practice address:** 6420 COUNCIL ST NE, CEDAR RAPIDS, IA 52402-1129
- **Practice address phone:** (212) 734-6621
- **Mailing address:** 199 LEE AVE, BROOKLYN, NY 11211-8919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/16/2024
- **Last updated:** 04/03/2024