NPIMap

Organization Active NPI

Olive Crest

  • Mental Illness Community Based Residential Treatment Facility
  • Perris, CA
National Provider Identifier
1285288316
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
OLIVE CREST
Practice address
23115 Rider St
Perris, CA 92570-9723
Phone
(951) 686-8500
NPI assigned
Jul 26, 2019
Last updated
Nov 5, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Authorized official

Name
Donald Verleur, MBA
Title
Ceo
Phone
(714) 543-5437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

23115 Rider St
Perris, CA 92570-9723

Mailing address

2130 E 4TH St Ste 200
Santa Ana, CA 92705-3818
Phone (714) 543-5437

National Provider Directory

National Provider Directory
Tax ID family
Olive Crest32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Locations

23115 Rider St
Perris, CA 92570
Phone 9516868500 ext. 4019

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572912000000",
    "number": "1285288316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 E 4TH ST STE 200",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053818",
            "telephone_number": "714-543-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23115 RIDER ST",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925709723",
            "telephone_number": "951-686-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE CREST",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-11-05",
        "status": "A",
        "authorized_official_last_name": "VERLEUR",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-543-5437",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perris, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.