=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194384867
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEGINNINGS BIRTH AND WELLNESS CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2019
-----------------------------------------------------
Last Update Date | 06/06/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7598 E PALO VERDE ST
-----------------------------------------------------
City | PRESCOTT VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86314-3255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-351-4664
-----------------------------------------------------
Fax | 928-351-1178
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1150
-----------------------------------------------------
City | DEWEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86327-1150
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-351-4664
-----------------------------------------------------
Fax | 928-351-1788
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JENNIFER DANIELLE RABINS
-----------------------------------------------------
Credential | CPM, LM
-----------------------------------------------------
Telephone | 928-351-4664
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QB0400X
-----------------------------------------------------
Taxonomy Name | Birthing Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------