Organization
LIFE TREE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES VANDEBRAKE (CEO)
(888) 354-6993
Entity
Organization
Contact information
Practice address
155 N RIVERVIEW DR, ANAHEIM, CA 92808-1225
(888) 354-6993
(909) 254-6800
Mailing address
155 N RIVERVIEW DR, ANAHEIM, CA 92808-1225
(888) 354-6993
(909) 254-6800
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
05/12/2022
Last updated
10/04/2022
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