Organization
TREE OF LIFE BEHAVIORAL HEALTH SERVICES PSYCHIATRIC NP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNE JEANNETTE NANS PNP FPMHNP (CEO)
(315) 286-0127
Entity
Organization
Contact information
Practice address
215 WASHINGTON ST, SUITE 221, WATERTOWN, NY 13601-3329
(315) 286-0127
Mailing address
215 WASHINGTON ST STE 102, WATERTOWN, NY 13601-3343
(315) 286-0127
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
7905039
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03410015
—
NY
Enumeration date
05/06/2013
Last updated
03/14/2023
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