NPIMap

Organization Active NPI

Tree of Life Arizona LLC

Doing business as Tree of Life Arizona

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Mesa, AZ
National Provider Identifier
1891193256
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
BH4477 Issued in AZ
Legal business name
TREE OF LIFE ARIZONA LLC
Doing business as
Tree of Life Arizona
Practice address
1659 E Draper Cir
Mesa, AZ 85203-6628
Phone
(480) 284-6498
Fax
(480) 350-7960
NPI assigned
Dec 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Authorized official

Name
Mr. Floyd Patterson II
Title
Founder/Ceo
Phone
(480) 284-6498

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X BH4477 AZ Primary

Addresses

Primary practice location

1659 E Draper Cir
Mesa, AZ 85203-6628

Mailing address

1659 E Draper Cir
Mesa, AZ 85203-6628
Phone (480) 284-6498

Other names 1

  • Tree of Life Arizona Doing business as

National Provider Directory

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

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1891193256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 E DRAPER CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852036628",
            "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": "1659 E DRAPER CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852036628",
            "telephone_number": "480-284-6498",
            "fax_number": "480-350-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREE OF LIFE ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-16",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "FLOYD",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "480-284-6498",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH4477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tree of Life Arizona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 16, 2014; 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.