Provider Demographics
NPI:1982856902
Name:TREES OF LIFE, LLC
Entity Type:Organization
Organization Name:TREES OF LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HAIRSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-988-4738
Mailing Address - Street 1:1796 TINKERMILL CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8585
Mailing Address - Country:US
Mailing Address - Phone:336-988-4738
Mailing Address - Fax:336-455-9175
Practice Address - Street 1:2208 SHARPE RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-8503
Practice Address - Country:US
Practice Address - Phone:336-455-9175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health