Provider Demographics
NPI:1922780568
Name:NATURE'S PALETTE THERAPEUTICS LLC
Entity Type:Organization
Organization Name:NATURE'S PALETTE THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-420-1897
Mailing Address - Street 1:PO BOX 143
Mailing Address - Street 2:
Mailing Address - City:TIERRA AMARILLA
Mailing Address - State:NM
Mailing Address - Zip Code:87575-0143
Mailing Address - Country:US
Mailing Address - Phone:720-515-6181
Mailing Address - Fax:
Practice Address - Street 1:14 PENINSULA DR
Practice Address - Street 2:
Practice Address - City:LOS OJOS
Practice Address - State:NM
Practice Address - Zip Code:87551
Practice Address - Country:US
Practice Address - Phone:720-515-6181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty