Provider Demographics
NPI:1083438642
Name:OLIVE TREE FAMILY SERVICES LLC
Entity type:Organization
Organization Name:OLIVE TREE FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISIOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RABB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-462-0392
Mailing Address - Street 1:5959 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5717
Mailing Address - Country:US
Mailing Address - Phone:716-332-1637
Mailing Address - Fax:716-931-5855
Practice Address - Street 1:5959 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5717
Practice Address - Country:US
Practice Address - Phone:716-332-1637
Practice Address - Fax:716-931-5855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty