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TREE OF LIFE BEHAVIORAL HEALTH SERVICES PSYCHIATRIC NP, P.C.

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Company Details

Name: TREE OF LIFE BEHAVIORAL HEALTH SERVICES PSYCHIATRIC NP, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 31 Oct 2013 (12 years ago)
Entity Number: 4480897
ZIP code: 13601
County: Jefferson
Place of Formation: New York
Address: 215 WASHINGTON STREET, SUITE 221, WATERTOWN, NY, United States, 13601

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 215 WASHINGTON STREET, SUITE 221, WATERTOWN, NY, United States, 13601

National Provider Identifier

NPI Number:
1285079137
Certification Date:
2023-03-14

Authorized Person:

Name:
MRS. ANNE JEANNETTE NANS
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QM0855X - Adolescent and Children Mental Health Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
131031000701 2013-10-31 CERTIFICATE OF INCORPORATION 2013-10-31

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State