| Organization Name: | CHANGING TREE WELLNESS CENTER, LLC |
| NPI Number: | 1245588409 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELLISA SCOTT (CEO/OWNER) |
| Mailing Address: | 203 Se 2nd Ave Okeechobee |
| State: | FL US |
| Postal Code: | 349744305 |
| Phone Number: | 8632618900 |
| Fax Number: | 8632791156 |
| NPI Enumeration Date: | 08/20/2012 |
| NPI Last Update Date: | 02/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | MH10761 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |