Provider Demographics
NPI:1427597376
Name:FAMILY TREE HEALTH CARE SYSTEMS
Entity Type:Organization
Organization Name:FAMILY TREE HEALTH CARE SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-454-9721
Mailing Address - Street 1:3672 N RANCHO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3149
Mailing Address - Country:US
Mailing Address - Phone:702-685-1600
Mailing Address - Fax:
Practice Address - Street 1:3672 N RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3149
Practice Address - Country:US
Practice Address - Phone:702-685-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV185175Medicaid