Tree of Life Mental Health Systems, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

TREE OF LIFE MENTAL HEALTH SYSTEMS, LLC

Practice address

8400 W. Virginia
#1138
Phoenix, AZ 85037

Phone

(702) 981-1153

Fax

(702) 974-4555

NPI assigned

Jul 28, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Brenton Kendyle Henderson

Title

Co-Owner

Phone

(702) 981-1153

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Tree of Life Mental Health Systems, LLC Doing business as

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1922522242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 W VIRGINIA AVE APT 1138",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850378370",
            "telephone_number": "702-981-1153",
            "fax_number": "702-974-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 W. VIRGINIA",
            "address_2": "#1138",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85037",
            "telephone_number": "702-981-1153",
            "fax_number": "702-974-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREE OF LIFE MENTAL HEALTH SYSTEMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "BRENTON",
        "authorized_official_middle_name": "KENDYLE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "702-981-1153",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609350608",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1069350608",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tree of Life Mental Health Systems, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tree of Life Mental Health Systems, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.