| Olive Crest | |
|
39820 Portola Ave Palm Desert CA 92260-0622 | |
| (760) 341-8507 | |
| (760) 341-8613 |
| Full Name | Olive Crest |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 39820 Portola Ave, Palm Desert, California |
| Authorized Official Name and Position | Donald A Verleur (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7145435437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Olive Crest 2130 E 4th St Ste 200 Santa Ana CA 92705-3818 Ph: (714) 543-5437 | Olive Crest 39820 Portola Ave Palm Desert CA 92260-0622 Ph: (760) 341-8507 |
| NPI Number | 1053861450 |
|---|---|
| Provider Enumeration Date | 10/10/2016 |
| Last Update Date | 11/15/2023 |
| Certification Date | 11/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053861450 | NPI | - | NPPES |
| LE0518 | Other | CA | MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 57111 (California) | Primary |
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