Olive Branch, LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

BH4335 Issued in AZ

Legal business name

OLIVE BRANCH, LLC

Practice address

411 W 9TH St
Casa Grande, AZ 85122-3204

Phone

(520) 423-7376

NPI assigned

Dec 23, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Kent P Volkmer, J.D., M.B.A

Title

Chief Executive Officer

Phone

(520) 423-7376

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387756800000",
    "number": "1386065159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W 9TH ST",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851223204",
            "telephone_number": "520-423-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W 9TH ST",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851223204",
            "telephone_number": "520-423-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-23",
        "last_updated": "2013-12-23",
        "status": "A",
        "authorized_official_last_name": "VOLKMER",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "520-423-7376",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "J.D., M.B.A"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH4335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Gregory Oladokun-Dybowski, LMSW
• Florence Adenike Oladokun, FNP
• Danielle Olivarez
• Olive Branch Assisted Living LLC
• Olive Branch Assisted Living LLC
• Olive Health and Wellness LLC
• Jessica R Oliver, FNP-C
• Zacaria Olivero
• Jennifer Olmos, RN, BSN
• Matthew Olsen, PA-C

• Emotionally Disturbed Childrens' Residential Treatment Facility in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; 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.