Provider Demographics
NPI:1790303162
Name:TREE OF LIFE CASE MANAGEMENT SERVICES CORP
Entity Type:Organization
Organization Name:TREE OF LIFE CASE MANAGEMENT SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:GUIGLOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-230-7449
Mailing Address - Street 1:12002 SW 128TH CT STE 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4643
Mailing Address - Country:US
Mailing Address - Phone:786-230-7449
Mailing Address - Fax:
Practice Address - Street 1:12002 SW 128TH CT STE 203
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4643
Practice Address - Country:US
Practice Address - Phone:786-230-7449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-11
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management