Provider Demographics
NPI:1386413888
Name:LIFE TREE COMMUNITY HEALTH CENTER, INC.
Entity type:Organization
Organization Name:LIFE TREE COMMUNITY HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:HASMIK
Authorized Official - Middle Name:
Authorized Official - Last Name:TOVMASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-486-6600
Mailing Address - Street 1:13750 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-2324
Mailing Address - Country:US
Mailing Address - Phone:818-486-6600
Mailing Address - Fax:
Practice Address - Street 1:13750 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-2324
Practice Address - Country:US
Practice Address - Phone:818-486-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health