Olive Branch Assisted Living LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

OLIVE BRANCH ASSISTED LIVING LLC

Practice address

1121 N Olive Ave
Casa Grande, AZ 85122-3418

Phone

(602) 618-3756

NPI assigned

Jul 5, 2022

Organization subpart

No

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

Authorized official

Name

Russell AppletonNPI 1386380996

Title

Manager

Phone

(602) 618-3756

Specialties & licenses 3

Addresses

Other identifiers 1

Tax ID family

Olive Branch Assisted Living LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Olive Branch Assisted Living LLC

  • Non-emergency Medical Transport (VAN)
  • Casa Grande, AZ
  • NPI 1801394861
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell Appleton

  • Mental Illness Community Based Residential Treatment Facility
  • Casa Grande, AZ
  • NPI 1386380996

  Psychiatric Residential Treatment Facility

  NPD Authorized official

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1245963610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4726 E WHITE ASTER ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444908",
            "telephone_number": "602-618-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 N OLIVE AVE",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851223418",
            "telephone_number": "602-618-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "APPLETON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-618-3756"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BH7438",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hunter Mackenzie Okeson, PA
• Simon Okuagu, PHARMD
• Daniel Gregory Oladokun-Dybowski, LMSW
• Florence Adenike Oladokun, FNP
• Danielle Olivarez
• Olive Branch Assisted Living LLC
• Olive Branch, LLC
• Olive Health and Wellness LLC
• Jessica R Oliver, FNP-C
• Zacaria Olivero

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.