# OLIVE GROVE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Olive Grove Residential Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699191775
- **Authorized official:** MR. ROYCE LONG (CORPORATE OFFICER/PRESIDENT)
- **Authorized official phone:** (714) 981-9081

## Contact information

- **Practice address:** 9446 BACK BAY CIR, LAS VEGAS, NV 89123-5947
- **Practice address phone:** (702) 413-6947
- **Practice address fax:** (702) 359-1983
- **Mailing address:** 723 E KIRKWALL RD, GLENDORA, CA 91740-5715
- **Mailing address phone:** (714) 981-9081
- **Mailing address fax:** (702) 359-1983

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 76654GC-1 | NV | Yes |

## Other

- **Enumeration date:** 03/12/2014
- **Last updated:** 03/12/2014