Provider Demographics
NPI:1003041989
Name:OLIVE TREE HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:OLIVE TREE HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OREDUNNI
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNTODU
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:972-237-1570
Mailing Address - Street 1:2307 OAK LN
Mailing Address - Street 2:BUILDING 2 A STE. # 221
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-4885
Mailing Address - Country:US
Mailing Address - Phone:972-237-1570
Mailing Address - Fax:972-237-1579
Practice Address - Street 1:2307 OAK LN
Practice Address - Street 2:BUILDING 2 A STE. # 221
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-4885
Practice Address - Country:US
Practice Address - Phone:972-237-1570
Practice Address - Fax:972-237-1579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health