NPIMap

Organization Active NPI

Tree of Life Arizona LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Mesa, AZ
National Provider Identifier
1144740572
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
BH5139 Issued in AZ
Legal business name
TREE OF LIFE ARIZONA LLC
Practice address
2935 E Dartmouth St
Mesa, AZ 85213-6907
Phone
(480) 241-9963
Fax
(480) 350-7960
NPI assigned
Jun 27, 2017
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
TREE OF LIFE ARIZONA LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessica P Patterson
Title
Administrator
Phone
(480) 241-9963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X BH5139 AZ Primary

Addresses

Primary practice location

2935 E Dartmouth St
Mesa, AZ 85213-6907

Mailing address

PO Box 2367
Mesa, AZ 85214-2367
Phone (480) 284-6498

Other practice location 1

321 W 9th St
Mesa, AZ 85201-4214
Phone (480) 284-6498

National Provider Directory

National Provider Directory
Tax ID family
Tree of Life Arizona LLC2 organizations share this tax ID, including this one
Part of
Tree of Life Arizona LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1144740572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2367",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852142367",
            "telephone_number": "480-284-6498",
            "fax_number": "480-350-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 E DARTMOUTH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852136907",
            "telephone_number": "480-241-9963",
            "fax_number": "480-350-7960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 W 9th St",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852014214",
            "country_code": "US",
            "telephone_number": "480-284-6498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TREE OF LIFE ARIZONA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TREE OF LIFE ARIZONA LLC",
        "enumeration_date": "2017-06-27",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-241-9963"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH5139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.