=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558241935
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRULIVING BIRTH CENTERS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/05/2025
-----------------------------------------------------
Last Update Date | 01/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 321 13TH ST SE
-----------------------------------------------------
City | MENOMONIE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54751-2032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-272-0527
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 321 13TH ST SE
-----------------------------------------------------
City | MENOMONIE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54751-2032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-272-0527
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FINANCIAL DIRECTOR
-----------------------------------------------------
Name | JACOB DETTINGER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 507-272-0527
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------