Provider Demographics
NPI:1689425373
Name:TREE OF LIFE HEALING AND RECOVERY LLC
Entity type:Organization
Organization Name:TREE OF LIFE HEALING AND RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:ROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:251-254-3350
Mailing Address - Street 1:PO BOX 823
Mailing Address - Street 2:
Mailing Address - City:FLOMATON
Mailing Address - State:AL
Mailing Address - Zip Code:36441-0823
Mailing Address - Country:US
Mailing Address - Phone:251-292-4143
Mailing Address - Fax:
Practice Address - Street 1:2118 RINGOLD ST
Practice Address - Street 2:
Practice Address - City:FLOMATON
Practice Address - State:AL
Practice Address - Zip Code:36441-5498
Practice Address - Country:US
Practice Address - Phone:251-292-4143
Practice Address - Fax:251-901-2953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health