NPIMap

Organization Active NPI

Olive Crest

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Santa Ana, CA
National Provider Identifier
1659878809
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
OLIVE CREST
Practice address
13442 Malena Dr
Santa Ana, CA 92705-1912
Phone
(714) 832-3629
Fax
(714) 731-4393
NPI assigned
Apr 12, 2018
Last updated
Jun 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

13442 Malena Dr
Santa Ana, CA 92705-1912

Mailing address

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

Other names 1

  • CYS Olive Crest Malena House Other name

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

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1659878809",
    "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": "13442 MALENA DR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927051912",
            "telephone_number": "714-832-3629",
            "fax_number": "714-731-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE CREST",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "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": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CYS Olive Crest Malena House",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CYS Olive Crest Malena House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.