Provider Demographics
NPI:1972174183
Name:FAMILY TREE HOLDINGS
Entity Type:Organization
Organization Name:FAMILY TREE HOLDINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:630-536-8501
Mailing Address - Street 1:1240 IROQUOIS AVE STE 404
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8540
Mailing Address - Country:US
Mailing Address - Phone:630-536-8501
Mailing Address - Fax:
Practice Address - Street 1:1240 IROQUOIS AVE STE 404
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8540
Practice Address - Country:US
Practice Address - Phone:630-536-8501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care