Provider Demographics
NPI:1063950608
Name:TREE OF LIFE MENTAL HEALTH SYSTEMS, LLC
Entity type:Organization
Organization Name:TREE OF LIFE MENTAL HEALTH SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REMILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:949-335-2263
Mailing Address - Street 1:9404 SHELLFISH CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-0267
Mailing Address - Country:US
Mailing Address - Phone:949-335-2263
Mailing Address - Fax:702-974-4445
Practice Address - Street 1:501 S RANCHO DR STE I62
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4838
Practice Address - Country:US
Practice Address - Phone:702-984-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20171013624251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health