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Organization
OLIVE CREST
Active
Organization
OLIVE CREST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD VERLEUR MBA (CHIEF EXECUTIVE OFFICER)
(714) 543-5437
Entity
Organization
Contact information
Practice address
39820 PORTOLA AVE, PALM DESERT, CA 92260-0622
(951) 686-8500
Mailing address
2130 E 4TH ST STE 200, SANTA ANA, CA 92705-3818
(714) 543-5437
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33JE
—
CA
Enumeration date
04/08/2010
Last updated
12/12/2023
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