Provider Demographics
NPI:1841670411
Name:FAMILY TREE BEHAVIORAL CARE, LLC
Entity type:Organization
Organization Name:FAMILY TREE BEHAVIORAL CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:E
Authorized Official - Last Name:JANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:239-218-0627
Mailing Address - Street 1:PO BOX 2161
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-2161
Mailing Address - Country:US
Mailing Address - Phone:941-404-3721
Mailing Address - Fax:941-296-7285
Practice Address - Street 1:1268 11TH ST UNIT 2103
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-3301
Practice Address - Country:US
Practice Address - Phone:941-404-3721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty