Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Olive Branch Behavioral Residencial Network, LLC

Organization Behavioral Neurology & Neuropsychiatry Physician · NPI 1215574496

Olive Branch Behavioral Residencial Network, LLC is a Behavioral Neurology & Neuropsychiatry Physician in Phoenix, Arizona. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2421 E Robert E Lee St
Phoenix, AZ 85032-1082
Phone: (602) 569-0806
Fax: (602) 569-0537
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavioral Neurology & Neuropsychiatry Physician (primary) Taxonomy 2084B0040X

Record details

NPI number1215574496
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tracy Ketchum — Cao,Administrator · (708) 277-8673
NPI enumeratedDecember 5, 2019
Last updated in NPPESDecember 5, 2019
Mailing address15712 W Eucalyptus Ct, Surprise, AZ 85374-3308

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