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General NPI Number Information
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NPI Number | 1962991687
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Entity Type | Organization
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Legal Business Name | TREE OF LIFE FAMILY BIRTH CENTER
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 1214 SPRING ST
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3704
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Country | US
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Telephone | 812-920-1580
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Fax |
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Provider Business Mailing Address
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Address Line | 301 GORDON GUTMANN BLVD STE 201
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3766
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Country | US
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Telephone | 812-282-6114
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MRS. ELIZABETH ANN QUINKERT
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Credential | CNM
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Telephone | 812-920-1580
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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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