MEDICARE: TREE OF LIFE LIVING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	251B00000X	Case Management Agency
3	177F00000X	Lodging Provider

General Provider Information

NPI Number	:	1215688130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TREE OF LIFE LIVING, LLC

Provider Business Mailing Address
First Line	:	3139 W HOLCOMBE BLVD STE 2155
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1533
Country	:	US
Telephone Number	:	281-671-2607
Fax Number	:

Provider Business Practice Location Address
First Line	:	7575 CAMBRIDGE ST APT 2603
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2036
Country	:	US
Telephone Number	:	281-827-5048
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FRANCINE L HAYNES
Credential	:	LMSW
Telephone Number	:	281-827-5048

Provider Enumeration Date	:	01/12/2022
Last Update Date	:	01/12/2022

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Directions to “TREE OF LIFE LIVING, LLC ” Practice Location

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