Provider Demographics
NPI:1437498342
Name:THE HEALTH TREE LLC
Entity Type:Organization
Organization Name:THE HEALTH TREE LLC
Other - Org Name:ADVANCED HEALTH & WELLNESS FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:731-968-2233
Mailing Address - Street 1:16570 HIGHWAY 104 N
Mailing Address - Street 2:ST B
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-3876
Mailing Address - Country:US
Mailing Address - Phone:731-968-2233
Mailing Address - Fax:731-968-2275
Practice Address - Street 1:16570 HIGHWAY 104 N
Practice Address - Street 2:ST B
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-3876
Practice Address - Country:US
Practice Address - Phone:731-968-2233
Practice Address - Fax:731-968-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12374363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty