Provider Demographics
NPI:1710239348
Name:TREE OF LIFE INC.
Entity Type:Organization
Organization Name:TREE OF LIFE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:THARANGA
Authorized Official - Middle Name:EKANAYAKE
Authorized Official - Last Name:MOHOTTIGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-698-9322
Mailing Address - Street 1:5364 BERKELEY RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-1612
Mailing Address - Country:US
Mailing Address - Phone:805-692-1111
Mailing Address - Fax:805-692-1111
Practice Address - Street 1:5364 BERKELEY RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-1612
Practice Address - Country:US
Practice Address - Phone:805-692-1111
Practice Address - Fax:805-692-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425801756310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility