Provider Demographics
NPI:1073392650
Name:FAMILY TREE PSYCHIATRIC CARE
Entity Type:Organization
Organization Name:FAMILY TREE PSYCHIATRIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:970-781-2040
Mailing Address - Street 1:111 E 3RD ST STE 221
Mailing Address - Street 2:
Mailing Address - City:RIFLE
Mailing Address - State:CO
Mailing Address - Zip Code:81650-2346
Mailing Address - Country:US
Mailing Address - Phone:970-781-2040
Mailing Address - Fax:970-781-2041
Practice Address - Street 1:111 E 3RD ST STE 221
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-2346
Practice Address - Country:US
Practice Address - Phone:970-781-2040
Practice Address - Fax:970-781-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)