OLIVE BRANCH BEHAVIORAL RESIDENCIAL NETWORK, LLC


Address: 2421 E Robert E Lee St, Phoenix, AZ 85032-1082
Phone: 6025690806

OLIVE BRANCH BEHAVIORAL RESIDENCIAL NETWORK, LLC (NPI# 1215574496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215574496
Entity Type Organization
Organization Name OLIVE BRANCH BEHAVIORAL RESIDENCIAL NETWORK, LLC
Practice Address 2421 E Robert E Lee St
Phoenix
AZ 85032-1082
Mailing Address 15712 W Eucalyptus Ct
Surprise
AZ 85374-3308
Practice Telephone 6025690806
Practice Fax Number 6025690537
Mailing Telephone 7082778673
Enumeration Date 2019-12-05
Last Update Date 2019-12-05
Authorized Official Name MS. TRACY BARSHELL KETCHUM (CAO,ADMINISTRATOR)
Authorized Official Telephone 7082778673
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084B0040X Psychiatry & Neurology
Specialization: Behavioral Neurology & Neuropsychiatry
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AZ BEHAVIORAL HEALTH 1028196670 01

Office Location

Street Address 2421 E ROBERT E LEE ST
City PHOENIX
State AZ
Zip Code 85032-1082

Providers in the same zip code

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Taxonomy Information

Taxonomy Code 2084B0040X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Behavioral Neurology & Neuropsychiatry

Taxonomy Definition

Behavioral Neurology & Neuropsychiatry is a medical subspecialty involving the diagnosis and treatment of neurologically based behavioral issues.
Notes: Source: National Uniform Claim Committee. [1/1/2012: new] Additional Resources: American Academy of Neurology, www.aan.com.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1184961674 Jack Edward Games Psychiatry & Neurology 4107 E Mcdonald Dr, Phoenix, AZ 85018-1116 2013-01-03
1336767516 Vital Healthcare Specialists LLC Psychiatry & Neurology 18444 N 25th Ave Ste 420, Phoenix, AZ 85023-1268 2020-07-14
1952532475 Po-heng Tsai Psychiatry & Neurology 901 E Willetta St, Phoenix, AZ 85006 2009-07-31

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1174093348 Yourx Health LLC Psychiatry & Neurology 2680 S Val Vista Dr Ste 185, Gilbert, AZ 85295-1674 2018-11-30
1497804827 Frederique P. Delhaye Psychiatry & Neurology 5750 E Highway 90 Ste 200, Sierra Vista, AZ 85635-9113 2007-01-08
1669914552 Northern Arizona Healthcare Corporation Psychiatry & Neurology 1200 N. Beaver Street, Attn: Payer Credentialing, Flagstaff, AZ 86001-3118 2016-11-09
1841693710 Mehmud Ahmed M D P C Psychiatry & Neurology 70 N Mcclintock Dr, Suite 4, Chandler, AZ 85226-3711 2014-10-06
1962802801 Aurora Behavioral Health Systems, LLC Psychiatry & Neurology 6015 W Peoria Ave, Glendale, AZ 85302-1213 2014-08-28
1528468782 Aurora Behavioral Healthcare - Tempe, LLC Psychiatry & Neurology 6350 S Maple Ave, Tempe, AZ 85283-2857 2014-08-25
1538593165 Sandra Leticia Combs Psychiatry & Neurology 1501 W Commerce Ct, Tucson, AZ 85746-6016 2013-08-30

Competitor

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City PHOENIX
Zip Code 85032

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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