OLIVE BRANCH BEHAVIORAL RESIDENCIAL NETWORK, LLC
NPI 1215574496
Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry in Phoenix, AZ

Q: What is Olive Branch Behavioral Residencial Network, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Behavioral Neurology & Neuropsychiatry, with taxonomy code 2084B0040X.

Active since December 05, 2019

2421 E ROBERT E LEE ST, PHOENIX, AZ 85032(602) 569-0806(602) 569-0537 Get Directions Write a Review

NPPES record last updated: December 5, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Olive Branch Behavioral Residencial Network, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLIVE BRANCH BEHAVIORAL RESIDENCIAL NETWORK, LLC (NPI 1215574496) is a healthcare organization registered as a behavioral neurology & neuropsychiatry in Phoenix, Arizona and active in the NPI registry since December 2019. The organization lists Tracy Barshell Ketchum, Cao,administrator, as its authorized official.

NPPES Registry Identity

NPI1215574496

Entity TypeOrganization

Primary Taxonomy2084B0040X

Legal Business NameOLIVE BRANCH BEHAVIORAL RESIDENCIAL NETWORK, LLC

Location Address2421 E ROBERT E LEE STPhoenix, AZ 85032-1082

Mailing Address15712 W Eucalyptus CtSurprise, AZ 85374-3308 · (708) 277-8673

Phone(602) 569-0806

Fax(602) 569-0537

Organization SubpartNo

Authorized OfficialTracy Barshell KetchumCao,administrator · (708) 277-8673

Enumeration DateDecember 5, 2019

✔ NPI 1215574496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Behavioral Neurology & NeuropsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084B0040X

Definition

Behavioral Neurology & Neuropsychiatry is a medical subspecialty involving the diagnosis and treatment of neurologically based behavioral issues.

2421 E ROBERT E LEE ST, Phoenix, AZ 85032

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Other Identifiers 1

Other1028196670AZ · Behavioral Health

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Olive Branch Behavioral Residencial Network, LLC's NPI number?

The NPI number for Olive Branch Behavioral Residencial Network, LLC is 1215574496. It was assigned to this organization in the NPPES registry on December 5, 2019.

Where is Olive Branch Behavioral Residencial Network, LLC located?

Olive Branch Behavioral Residencial Network, LLC is located at 2421 E Robert E Lee St, Phoenix, AZ 85032. The listed phone number is (602) 569-0806.

What is Olive Branch Behavioral Residencial Network, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Behavioral Neurology & Neuropsychiatry, with taxonomy code 2084B0040X.

When was this NPI record last updated?

The NPPES record for Olive Branch Behavioral Residencial Network, LLC was last updated on December 5, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.