Healthcare Provider Details

I. General information

NPI: 1134996812
Provider Name (Legal Business Name): BEAUTIFUL BEGINNINGS COMMUNITY BIRTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 12/04/2023
Certification Date: 12/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 E BOGARD ROAD
WASILLA AK
99654
US

IV. Provider business mailing address

PO BOX 839
KENAI AK
99611-0839
US

V. Phone/Fax

Practice location:
  • Phone: 907-394-3339
  • Fax:
Mailing address:
  • Phone: 907-394-3339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ANDREA STIERS
Title or Position: MEMBER/ CO-OWNER
Credential:
Phone: 907-394-3339