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General NPI Number Information
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NPI Number | 1710239348
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Entity Type | Organization
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Legal Business Name | TREE OF LIFE INC.
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 5364 BERKELEY RD
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City | SANTA BARBARA
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State | CA
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Zip | 93111-1612
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Country | US
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Telephone | 805-692-1111
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Fax | 805-692-1111
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Provider Business Mailing Address
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Address Line | 5364 BERKELEY RD
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City | SANTA BARBARA
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State | CA
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Zip | 93111-1612
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Country | US
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Telephone | 805-692-1111
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Fax | 805-692-1111
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. THARANGA EKANAYAKE MOHOTTIGE
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Credential |
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Telephone | 805-698-9322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 425801756
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License Number State | CA
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