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General NPI Number Information
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NPI Number | 1063950608
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Entity Type | Organization
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Legal Business Name | Tree Of Life Mental Health Systems, LLC
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 501 Rancho Dr. Suite I-62
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City | LAS VEGAS
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State | NV
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Zip | 89106-2142
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Country | US
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Telephone | 702-984-6500
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Fax | 702-974-4555
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Provider Business Mailing Address
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Address Line | 501 Rancho Dr. Suite #I-62
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City | LAS VEGAS
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State | NV
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Zip | 89106
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Country | US
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Telephone | 702-984-6500
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Fax | 702-974-4445
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | MRS. REMILYN HENDERSON
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Credential | LVN
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Telephone | 949-335-2263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health
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License Number | NV20171013624
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License Number State | NV
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