Provider Demographics
NPI:1841316379
Name:THE PALAVRA TREE, INC.
Entity type:Organization
Organization Name:THE PALAVRA TREE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CLEO
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-263-7768
Mailing Address - Street 1:1212 S 43RD ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92113-3454
Mailing Address - Country:US
Mailing Address - Phone:619-263-7768
Mailing Address - Fax:619-262-5040
Practice Address - Street 1:1212 S 43RD ST STE C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-3454
Practice Address - Country:US
Practice Address - Phone:619-263-7768
Practice Address - Fax:619-262-5040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management