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Organization
OLIVE CREST
Active
Organization
OLIVE CREST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD A VERLEUR II MBA (CHIEF EXECUTIVE OFFICER)
(714) 543-5437
Entity
Organization
Contact information
Practice address
555 TECHNOLOGY CT, RIVERSIDE, CA 92507-2155
(951) 686-8500
(951) 369-3037
Mailing address
2130 E. 4TH ST., SUITE 200, SANTA ANA, CA 92705-3810
(714) 543-5437
(714) 543-5463
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
57111
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LE0518
MEDI-CAL
CA
Enumeration date
03/18/2008
Last updated
11/04/2024
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