=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477417020
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE BIRTH HAVEN LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/09/2025
-----------------------------------------------------
Last Update Date | 12/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 403 MARQUIS AVE STE 100
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40502-2129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-553-1973
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 515 CLAY LICK RD
-----------------------------------------------------
City | SALVISA
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40372-9577
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-553-1973
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JULIE A SIX
-----------------------------------------------------
Credential | DOULA
-----------------------------------------------------
Telephone | 859-553-1973
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------