| Olive Branches, Llc | |
|
509 Maple St Coffeyville KS 67337-4814 | |
| (620) 515-1907 | |
| (620) 222-9316 |
| Full Name | Olive Branches, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 509 Maple St, Coffeyville, Kansas |
| Authorized Official Name and Position | Shaun Meek (OWNER) |
| Authorized Official Contact | 6205151907 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Olive Branches, Llc Po Box 1 Coffeyville KS 67337-0001 Ph: (620) 515-1907 | Olive Branches, Llc 509 Maple St Coffeyville KS 67337-4814 Ph: (620) 515-1907 |
| NPI Number | 1538650783 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 07/15/2024 |
| Certification Date | 07/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538650783 | NPI | - | NPPES |
| 201085500A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 2773 (Kansas) | Primary |
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