Organization
A FAMILY TREE ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHELLI ANN PAYNE (RESIDENTAL PROVIDER FOR THE DISABL)
(913) 766-3059
Entity
Organization
Contact information
Practice address
6501 W 138TH TERR APARTMENT 1011, OVERLAND PARK, KS 66223
(913) 766-3059
Mailing address
6501 W 138TH TER, OVERLAND PARK, KS 66223-7942
(913) 304-9461
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200690170
KMAP NUMBER
MO
01
—
200690170A
KMAP NUMBER
MO
Enumeration date
10/31/2011
Last updated
07/21/2022
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