# A FAMILY TREE ENTERPRISES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114203478
- **Authorized official:** MRS. CHELLI ANN PAYNE (RESIDENTAL PROVIDER FOR THE DISABL)
- **Authorized official phone:** (913) 766-3059

## Contact information

- **Practice address:** 6501 W 138TH TERR APARTMENT 1011, OVERLAND PARK, KS 66223
- **Practice address phone:** (913) 766-3059
- **Mailing address:** 6501 W 138TH TER, OVERLAND PARK, KS 66223-7942
- **Mailing address phone:** (913) 304-9461

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | KS | Yes |

## Other

- **Enumeration date:** 10/31/2011
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 200690170 | KMAP NUMBER | MO |
| 01 | — | 200690170A | KMAP NUMBER | MO |