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General NPI Number Information
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NPI Number | 1043789613
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Entity Type | Organization
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Legal Business Name | PRIVATE HEALTHCARE FACILITIES
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 06/09/2024
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Provider Practice Location Address
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Address Line | 1040 E BROADWAY ST STE B
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City | GOLDENDALE
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State | WA
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Zip | 98620-9154
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Country | US
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Telephone | 866-996-2340
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Fax |
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Provider Business Mailing Address
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Address Line | 902 KITTY HAWK RD # 170487
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City | UNIVERSAL CITY
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State | TX
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Zip | 78148-3825
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Country | US
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Telephone | 866-996-2340
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Fax | 888-329-2091
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Authorized Official
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Title or Position | OFFICE STAFF
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Name | MS. PRISCILLA HOLLINGSWORTH
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Credential |
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Telephone | 866-996-2340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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