Provider Demographics
NPI:1518723030
Name:THREE TREES MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:THREE TREES MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:COVARRUBIAS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:401-753-8950
Mailing Address - Street 1:769 CENTRE ST STE 329
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2557
Mailing Address - Country:US
Mailing Address - Phone:401-753-8950
Mailing Address - Fax:617-518-4304
Practice Address - Street 1:769 CENTRE ST STE 329
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-2557
Practice Address - Country:US
Practice Address - Phone:401-753-8950
Practice Address - Fax:617-518-4304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty