| Family Tree Associates, Llc | |
|
1125 W 4th St Waterloo IA 50702-2845 | |
| (319) 287-5516 | |
| (319) 226-5260 |
| Full Name | Family Tree Associates, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1125 W 4th St, Waterloo, Iowa |
| Authorized Official Name and Position | Rita M. Spears (EXECUTIVE OFFICER) |
| Authorized Official Contact | 3192694051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Tree Associates, Llc Po Box 1947 Waterloo IA 50704-1947 Ph: (319) 287-5516 | Family Tree Associates, Llc 1125 W 4th St Waterloo IA 50702-2845 Ph: (319) 287-5516 |
| NPI Number | 1336357557 |
|---|---|
| Provider Enumeration Date | 05/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336357557 | NPI | - | NPPES |
| 1011379 | Medicaid | IA | |
| 29-07-019 | Other | IA | RTS SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 29-07-019 (Iowa) | Primary |
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