| Tree Of Life Heathcare, Inc. | |
|
1968 North Ave Columbus GA 31901-1525 | |
| (706) 225-0355 | |
| (706) 225-0360 |
| Full Name | Tree Of Life Heathcare, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1968 North Ave, Columbus, Georgia |
| Authorized Official Name and Position | Lowell Cliatt (PRESIDENT / CEO) |
| Authorized Official Contact | 7062250355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tree Of Life Heathcare, Inc. Po Box 9205 Columbus GA 31908-9205 Ph: (706) 225-0355 | Tree Of Life Heathcare, Inc. 1968 North Ave Columbus GA 31901-1525 Ph: (706) 225-0355 |
| NPI Number | 1811326655 |
|---|---|
| Provider Enumeration Date | 11/02/2013 |
| Last Update Date | 11/02/2013 |
| Medicare PECOS PAC ID | 9234406539 |
|---|---|
| Medicare Enrollment ID | O20170516002318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811326655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | RN085223 (Georgia) | Primary |
| Provider Name | Beulette Y Hooks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952401747 PECOS PAC ID: 5698731925 Enrollment ID: I20041208000173 |
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