# OAK TREE SUPPORTED LIVING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437066826
- **Authorized official:** HEIDI PROVENCE (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (208) 620-1477

## Contact information

- **Practice address:** 522 W RIVERSIDE AVE, SPOKANE, WA 99201-0580
- **Practice address phone:** (208) 620-1477
- **Mailing address:** 1390 E ELDERBERRY CIR, COEUR D ALENE, ID 83815-6559
- **Mailing address phone:** (208) 620-1477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/24/2026
- **Last updated:** 08/24/2026