Provider Demographics
NPI:1093253478
Name:TREE OF LIFE TRANSPORTATION
Entity Type:Organization
Organization Name:TREE OF LIFE TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-673-6947
Mailing Address - Street 1:5067 RAINMAKER DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2299
Mailing Address - Country:US
Mailing Address - Phone:919-973-6947
Mailing Address - Fax:
Practice Address - Street 1:5067 RAINMAKER DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2299
Practice Address - Country:US
Practice Address - Phone:919-973-6947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child