Organization
OLIVE BRANCH SUPPORTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY SCOTT (OWNER)
(702) 747-1066
Entity
Organization
Contact information
Practice address
6012 HARVEST DANCE ST, NORTH LAS VEGAS, NV 89031-2063
(702) 747-1066
Mailing address
6012 HARVEST DANCE ST, NORTH LAS VEGAS, NV 89031-2063
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NV20151522250
NV
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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