Provider Demographics
NPI:1578849030
Name:THE FAMILY TREE CARE SERVICES
Entity Type:Organization
Organization Name:THE FAMILY TREE CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-895-9998
Mailing Address - Street 1:13117 EASTPOINT PARK BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4193
Mailing Address - Country:US
Mailing Address - Phone:502-895-9998
Mailing Address - Fax:502-254-2225
Practice Address - Street 1:13117 EASTPOINT PARK BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4193
Practice Address - Country:US
Practice Address - Phone:502-895-9998
Practice Address - Fax:502-254-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500124251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY500124OtherSTATE LICENCE