Provider Demographics
NPI:1699142356
Name:TREE OF LIFE ELDER CARE, INC
Entity type:Organization
Organization Name:TREE OF LIFE ELDER CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MONTGOMERY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTRANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DD, MSW, MBA
Authorized Official - Phone:619-913-2666
Mailing Address - Street 1:1308 HACIENDA DR
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-1324
Mailing Address - Country:US
Mailing Address - Phone:619-913-2666
Mailing Address - Fax:619-599-8161
Practice Address - Street 1:1308 HACIENDA DR
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1324
Practice Address - Country:US
Practice Address - Phone:619-913-2666
Practice Address - Fax:619-599-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374602652311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home