NPIMap

Organization Active NPI

Olive Crest

  • Community/Behavioral Health Agency
  • Las Vegas, NV
National Provider Identifier
1396950374
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
OLIVE CREST
Practice address
4285 N Rancho Dr Ste 160
Las Vegas, NV 89130-3456
Phone
(702) 685-3459
Fax
(702) 851-8528
NPI assigned
May 11, 2007
Last updated
Apr 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Authorized official

Name
Mr. Donald A. Verleur II, MBA
Title
Chief Executive Officer
Phone
(714) 543-5437

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X NV
Community/Behavioral Health Agency 251S00000X NV Primary

Addresses

Primary practice location

4285 N Rancho Dr Ste 160
Las Vegas, NV 89130-3456

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
100508325MedicaidNV
100508320MedicaidNV
100508326MedicaidNV

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

4285 N Rancho Dr
Ste 160
Las Vegas, NV 89130
Phone (702) 324-7061

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1396950374",
    "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",
            "fax_number": "714-543-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4285 N RANCHO DR STE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303456",
            "telephone_number": "702-685-3459",
            "fax_number": "702-851-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE CREST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "VERLEUR",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "714-543-5437",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "NV",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508325",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508320",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508326",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.