Olive Branch Supportive Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

NV20151522250 Issued in NV

Legal business name

OLIVE BRANCH SUPPORTIVE SERVICES LLC

Practice address

6012 Harvest Dance St
North Las Vegas, NV 89031-2063

Phone

(702) 747-1066

NPI assigned

Oct 7, 2015

Organization subpart

No

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

Authorized official

Name

Tiffany Scott

Title

Owner

Phone

(702) 747-1066

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1194196881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6012 HARVEST DANCE ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890312063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6012 HARVEST DANCE ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890312063",
            "telephone_number": "702-747-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH SUPPORTIVE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-747-1066"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": "NV20151522250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julian Olivares
• Jessica Olivarez
• Mariana Lysseth Olivas Amador
• Asaf Olivas Estebane
• Olive Branch Mentoring
• Demarrius Oliver
• Margaret Marie Oliver, LCSW
• Michael Phillip Oliver
• Jailon Javier Olivera Lopez
• Miguel M Ollada, MD

• Community/Behavioral Health Agency in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.