Provider Demographics
NPI:1285445528
Name:OLIVE HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:OLIVE HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:LOVE
Authorized Official - Middle Name:OLANREWAJU
Authorized Official - Last Name:OLALEYE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:864-428-7358
Mailing Address - Street 1:3819 STATE HIGHWAY 34 S STE D
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-5121
Mailing Address - Country:US
Mailing Address - Phone:864-428-7358
Mailing Address - Fax:
Practice Address - Street 1:3819 STATE HIGHWAY 34 S STE D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-5121
Practice Address - Country:US
Practice Address - Phone:864-428-7358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty