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OLIVE GROVE LLC NPI 1699191775


NPI Information

NPI: 1699191775
Provider Name: OLIVE GROVE LLC

Doing Business As: OLIVE GROVE RESIDENTIAL CARE

Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
9446 BACK BAY CIR
LAS VEGAS, NV
ZIP 89123
Phone: (702) 413-6947
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OLIVE GROVE LLC is an adult care home custodial care facility in Las Vegas, NV. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. OLIVE GROVE LLC NPI is 1699191775. The provider is registered as an organization entity type.
The provider Is Doing Business As Olive Grove Residential Care.

The provider's business location address is:

9446 BACK BAY CIR
LAS VEGAS, NV
ZIP 89123-947
Phone: (702) 413-6947
Fax: (702) 359-1983

The provider's authorized official is Royce Long .
The authorized official title is Corporate Officer/president and has the following contact phone number (714) 981-9081.

The enumeration date for this NPI number is 3/12/2014 and was last updated on 3/12/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care Home76654GC-1NEVADAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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