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Organization

TREE OF LIFE RESIDENTIAL CARE,LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA HOPE GRIFFITH (ADMINSTRATOR)
(931) 581-3728
Entity
Organization

Contact information

Practice address
293 KING RD, TRACY CITY, TN 37387-4613
(931) 581-3728
Mailing address
615 JOHNNY STIEFEL RD, SEQUATCHIE, TN 37374-6158
(931) 581-3728

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15775373
CAQH
TN
Enumeration date
11/17/2022
Last updated
12/13/2022
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