Provider Demographics
NPI:1396038253
Name:OLIVE HOME HEALTH CARE
Entity Type:Organization
Organization Name:OLIVE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:OLUKEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLASUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-560-5608
Mailing Address - Street 1:12431 NEWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-3911
Mailing Address - Country:US
Mailing Address - Phone:281-564-5764
Mailing Address - Fax:281-564-5764
Practice Address - Street 1:12431 NEWBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-3911
Practice Address - Country:US
Practice Address - Phone:281-564-5764
Practice Address - Fax:281-564-5764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011312251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care