Provider Demographics
NPI:1437571221
Name:OLIVE BRANCH MANAGEMENT, LLC
Entity Type:Organization
Organization Name:OLIVE BRANCH MANAGEMENT, LLC
Other - Org Name:CARING DOCTORS HOME VISITS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:214-277-9516
Mailing Address - Street 1:600 SIX FLAGS DR
Mailing Address - Street 2:SUITE 452
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-6346
Mailing Address - Country:US
Mailing Address - Phone:469-337-7089
Mailing Address - Fax:
Practice Address - Street 1:600 SIX FLAGS DR
Practice Address - Street 2:SUITE 452
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-6346
Practice Address - Country:US
Practice Address - Phone:469-337-7089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty