| Organization Name: | OUR FAMILY TREE |
| NPI Number: | 1972861193 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTONIO DANIEL DISTANCE (PRESIDENT / C.E.O) |
| Mailing Address: | 1203 Lakeside Ave Baltimore |
| State: | MD US |
| Postal Code: | 212183002 |
| Phone Number: | 4436080401 |
| Fax Number: | 4102432246 |
| NPI Enumeration Date: | 04/25/2012 |
| NPI Last Update Date: | 04/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | R3139 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |