MEDICARE: FAMILY TREE HEALTH CARE SYSTEMS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1851759021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY TREE HEALTH CARE SYSTEMS INC

Provider Business Mailing Address
First Line	:	3672 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3149
Country	:	US
Telephone Number	:	702-218-7667
Fax Number	:

Provider Business Practice Location Address
First Line	:	3672 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3149
Country	:	US
Telephone Number	:	702-218-7667
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ROSE GASTON
Credential	:
Telephone Number	:	702-218-7667

Provider Enumeration Date	:	02/03/2016
Last Update Date	:	02/03/2016

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