| Tree Of Life Behavioral Health Services Psychiatric Np, Pc | |
|
215 Washington St Suite 221 Watertown NY 13601-3329 | |
| (315) 286-0127 | |
| Not Available |
| Full Name | Tree Of Life Behavioral Health Services Psychiatric Np, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 215 Washington St, Watertown, New York |
| Authorized Official Name and Position | Anne Jeannette Nans (CEO) |
| Authorized Official Contact | 3152860127 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tree Of Life Behavioral Health Services Psychiatric Np, Pc 215 Washington St Ste 102 Watertown NY 13601-3343 Ph: (315) 286-0127 | Tree Of Life Behavioral Health Services Psychiatric Np, Pc 215 Washington St Suite 221 Watertown NY 13601-3329 Ph: (315) 286-0127 |
| NPI Number | 1285079137 |
|---|---|
| Provider Enumeration Date | 05/06/2013 |
| Last Update Date | 03/14/2023 |
| Certification Date | 03/14/2023 |
| Medicare PECOS PAC ID | 7810138021 |
|---|---|
| Medicare Enrollment ID | O20250226001967 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285079137 | NPI | - | NPPES |
| 03410015 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 7905039 (New York) | Primary |
| Provider Name | Anne Jeannette Nans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558582411 PECOS PAC ID: 1456592666 Enrollment ID: I20150313000816 |
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