The Olive Foundation LLC

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

THE OLIVE FOUNDATION LLC

Doing business as

Breeze of Hope Restoration Home

Practice address

3108 S 78TH LN
Phoenix, AZ 85043-1253

Phone

(623) 248-8574

Fax

(602) 429-8462

NPI assigned

Dec 28, 2021

Organization subpart

No

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

Authorized official

Name

Charles Ogu

Title

Owner

Phone

(602) 612-2231

Specialties & licenses 1

Addresses

Other names 1

• Breeze of Hope Restoration Home Doing business as

Tax ID family

Breeze of Hope Restoration Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• The Olive Foundation

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1669080644
  NPD tax ID
• The Olive Foundation LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Chandler, AZ
  • NPI 1598402216
  NPD tax ID

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1184384497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6638 S 6TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415764",
            "telephone_number": "202-640-0238",
            "fax_number": "602-429-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 S 78TH LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850431253",
            "telephone_number": "623-248-8574",
            "fax_number": "602-429-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OLIVE FOUNDATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-28",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "OGU",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-612-2231"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breeze of Hope Restoration Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility (Behavioral Disturbances) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Assisted Living Facility (Behavioral Disturbances) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.