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General NPI Number Information
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NPI Number | 1982493219
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Entity Type | Organization
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Legal Business Name | THE GENESIS RESORT FOR BIRTH, LLC
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 905 BAYLOR ST
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City | STAUNTON
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State | VA
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Zip | 24401-2075
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Country | US
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Telephone | 540-569-6745
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Fax | 540-900-2414
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Provider Business Mailing Address
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Address Line | 905 BAYLOR ST
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City | STAUNTON
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State | VA
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Zip | 24401-2075
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Country | US
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Telephone | 540-569-6745
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Fax | 540-900-2414
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER SOPER
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Credential | CNM
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Telephone | 540-569-6745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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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 | 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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