1346404613 NPI number — THE TREE OF LIFE MINISTRIES

Table of content: (NPI 1346404613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346404613 NPI number — THE TREE OF LIFE MINISTRIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE TREE OF LIFE MINISTRIES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
INSTITUTE FOR CHILD & FAMILY DEVELOPMENT-ARIZONA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346404613
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1921 S ALMA SCHOOL RD
Provider Second Line Business Mailing Address:
SUITE 315
Provider Business Mailing Address City Name:
MESA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85210-3036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-755-5553
Provider Business Mailing Address Fax Number:
480-755-2199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1921 S ALMA SCHOOL RD
Provider Second Line Business Practice Location Address:
SUITE 315
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85210-3036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-755-5553
Provider Business Practice Location Address Fax Number:
480-755-2199
Provider Enumeration Date:
07/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS-MCCARTY
Authorized Official First Name:
NORMA
Authorized Official Middle Name:
GAIL
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
480-755-5553

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  LMSW 9918 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com