Provider Demographics
NPI:1548013402
Name:INTEGRITY OLIVE TREES LLC
Entity type:Organization
Organization Name:INTEGRITY OLIVE TREES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:EVANS
Authorized Official - Middle Name:YEBOAH
Authorized Official - Last Name:ADDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-668-3775
Mailing Address - Street 1:2600 COMMERCIAL AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-4822
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2600 COMMERCIAL AVE APT 4
Practice Address - Street 2:
Practice Address - City:SOUTH CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-4822
Practice Address - Country:US
Practice Address - Phone:708-668-3775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health