Provider Demographics
NPI:1992692404
Name:TREE OF LIFE SUPPORTS & SERVICES, LLC
Entity type:Organization
Organization Name:TREE OF LIFE SUPPORTS & SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:K
Authorized Official - Last Name:STOKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-365-4411
Mailing Address - Street 1:4232 S BLACKHAWK CIR UNIT 5H
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-8112
Mailing Address - Country:US
Mailing Address - Phone:720-365-4411
Mailing Address - Fax:
Practice Address - Street 1:4232 S BLACKHAWK CIR UNIT 5H
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-8112
Practice Address - Country:US
Practice Address - Phone:720-365-4411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services