Olive Branch Residential, LLC
NPI #1225127426 in Olive Branch, Mississippi
Provider Information
- NPI Number
- 1225127426
- Entity Type
- Organization
- Organization Name
- Olive Branch Residential, LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Oct 12, 2006
- Last Updated
- Aug 15, 2008
Practice Location
- Address
- 9684 OLD GOODMAN ROAD
- City
- Olive Branch
- State
- Mississippi
- ZIP Code
- 38654
- Phone
- (662) 895-7609
Authorized Official
- Name
- JAMES REIKER
- Title
- TREASURER
- Phone
- (662) 895-7609
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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