Provider Demographics
NPI:1730817701
Name:TREE'S OF LIFE HOMECARE LLC
Entity type:Organization
Organization Name:TREE'S OF LIFE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WILGENIA
Authorized Official - Middle Name:LOCHONA
Authorized Official - Last Name:STARKS
Authorized Official - Suffix:
Authorized Official - Credentials:OWN
Authorized Official - Phone:770-688-5763
Mailing Address - Street 1:517 BRENSTON CT
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-4903
Mailing Address - Country:US
Mailing Address - Phone:770-688-5763
Mailing Address - Fax:404-343-1071
Practice Address - Street 1:517 BRENSTON CT
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-4903
Practice Address - Country:US
Practice Address - Phone:770-688-5763
Practice Address - Fax:404-343-1071
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TREE'S OF LIFE HOMECARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health