Healthcare Provider Details

I. General information

NPI: 1700501814
Provider Name (Legal Business Name): COMMUNITY BIRTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 TRAIL VIEW LN SE
PINE ISLAND MN
55963-8608
US

IV. Provider business mailing address

216 TOWER RD
SAN ANTONIO TX
78223-6018
US

V. Phone/Fax

Practice location:
  • Phone: 800-341-8598
  • Fax:
Mailing address:
  • Phone: 210-464-3611
  • Fax: 888-329-2091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ERIKA LEWIS
Title or Position: OFFICE STAFF
Credential:
Phone: 210-464-3611