Provider Demographics
NPI:1548438732
Name:RIGHTEOUS TREES LLC
Entity type:Organization
Organization Name:RIGHTEOUS TREES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:FANE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-650-6421
Mailing Address - Street 1:11438 PINEVIEW CROSSING DRIVE
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-5104
Mailing Address - Country:US
Mailing Address - Phone:314-650-6421
Mailing Address - Fax:314-738-0153
Practice Address - Street 1:11438 PINEVIEW CROSSING DRIVE
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-5104
Practice Address - Country:US
Practice Address - Phone:314-650-6421
Practice Address - Fax:314-738-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004004692251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health