Provider Demographics
NPI:1326740564
Name:TREE OF LIFE COUNSELING AND MINISTRIES
Entity Type:Organization
Organization Name:TREE OF LIFE COUNSELING AND MINISTRIES
Other - Org Name:TREE OF LIFE COUNSELING CENTER AND FOUNDATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAMELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LESLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-542-4430
Mailing Address - Street 1:14896 FAVERSHAM CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4106
Mailing Address - Country:US
Mailing Address - Phone:407-358-7188
Mailing Address - Fax:
Practice Address - Street 1:101 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9027
Practice Address - Country:US
Practice Address - Phone:407-358-7188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health