Organization
OLIVE CREST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD A. VERLEUR II MBA (CHIEF EXECUTIVE OFFICER)
(714) 543-5437
Entity
Organization
Contact information
Practice address
4285 N RANCHO DR STE 160, LAS VEGAS, NV 89130-3456
(702) 685-3459
(702) 851-8528
Mailing address
2130 E 4TH ST STE 200, SANTA ANA, CA 92705-3818
(714) 543-5437
(714) 543-5463
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NV
253J00000X
Foster Care Agency
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100508320
—
NV
05
—
100508325
—
NV
05
—
100508326
—
NV
Enumeration date
05/11/2007
Last updated
04/11/2018
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