MEDICARE: FAMILY TREE 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	261QA0005X	Ambulatory Family Planning Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952417412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY TREE INC

Provider Business Mailing Address
First Line	:	1919 NICOLLET AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403-3747
Country	:	US
Telephone Number	:	612-473-0800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 NICOLLET AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403
Country	:	US
Telephone Number	:	612-473-0800
Fax Number	:

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	WILLOW NICHOLS
Credential	:
Telephone Number	:	612-473-0812

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	05/13/2026

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Directions to “FAMILY TREE INC ” Practice Location

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