Olive Branch Communities LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

OLIVE BRANCH COMMUNITIES LLC

Practice address

515 E Main St
Waterford, WI 53185-4428

Phone

(262) 342-0200

NPI assigned

Apr 8, 2022

Last updated

Apr 8, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adriane Nelson

Title

Ceo

Phone

(262) 342-0200

Specialties & licenses 5

Addresses

Other names 1

• ANA Living LLC Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1093457210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531050532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E MAIN ST",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531854428",
            "telephone_number": "262-342-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH COMMUNITIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ADRIANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-342-0200"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANA Living LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Joanne Marie Narut, PHARM.D. R.PH.
• Navie Comfort Living Services
• Iryna Nemesh, M.D.
• Gregg Eric Nielsen, D.C.
• Cara P Obst, OTA
• Kristen Ann Orlando, PT
• Rosemary Palmer, OTR
• Rachel Anne Pankonin
• James Alan Para-Cremer, M.A.
• Andrea L Parisi, OD

• Adult Care Home Facility in Waterford, WI
• Providers in Waterford, WI by specialty
• Adult Care Home Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.