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
15235 CORNUTA AVE, BELLFLOWER, CA 90706-3907
(562) 866-8956
(562) 866-4158
Mailing address
2130 E 4TH ST, SUITE 200, SANTA ANA, CA 92705-3818
(714) 543-5434
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7269
—
CA
Enumeration date
02/26/2007
Last updated
04/11/2018
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