Healthcare Provider Details

I. General information

NPI: 1255295259
Provider Name (Legal Business Name): A MOTHER'S VILLAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 WARRIOR LN
BOWLING GREEN KY
42104-8821
US

IV. Provider business mailing address

1240 WARRIOR LN
BOWLING GREEN KY
42104-8821
US

V. Phone/Fax

Practice location:
  • Phone: 270-938-3404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILY KAISER
Title or Position: OWNER
Credential:
Phone: 270-938-3404