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General NPI Number Information
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NPI Number | 1831733021
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Entity Type | Organization
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Legal Business Name | GENESIS BIRTH SERVICES LLC
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Dates
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Enumeration Date | 10/31/2019
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 1307 PARK AVE #10
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-2610
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Country | US
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Telephone | 717-970-3009
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Fax | 717-970-3009
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Provider Business Mailing Address
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Address Line | 1307 PARK AVE #10
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City | WILLIAMSPORT
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State | PA
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Zip | 17701
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Country | US
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Telephone | 717-970-3009
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. GERRIA COFFEE
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Credential | CLC CD CBE CHW MH MA
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Telephone | 717-970-3009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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