Healthcare Provider Details

I. General information

NPI: 1013849025
Provider Name (Legal Business Name): TREES OF LIFE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 LEE ST NE STE A
DECATUR AL
35601-1751
US

IV. Provider business mailing address

123 LEE ST NE STE A
DECATUR AL
35601-1751
US

V. Phone/Fax

Practice location:
  • Phone: 256-822-8492
  • Fax:
Mailing address:
  • Phone: 256-822-8492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: INGRID FUQUA
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential:
Phone: 256-822-8492