Provider Demographics
NPI:1891953725
Name:OLIVE GLEN FOUNDATION INC
Entity Type:Organization
Organization Name:OLIVE GLEN FOUNDATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CHRISTIAN SCIENCE NURSI
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-486-4382
Mailing Address - Street 1:3025 BECERRA WY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821
Mailing Address - Country:US
Mailing Address - Phone:916-486-1161
Mailing Address - Fax:916-484-7010
Practice Address - Street 1:3025 BECERRA WY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821
Practice Address - Country:US
Practice Address - Phone:916-486-1161
Practice Address - Fax:916-484-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution