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General NPI Number Information
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NPI Number | 1982585469
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Entity Type | Organization
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Legal Business Name | DESERT BLOOM BIRTH CENTER LLC
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 875 N GREENFIELD RD STE 101
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City | GILBERT
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State | AZ
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Zip | 85234-5044
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Country | US
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Telephone | 480-664-7463
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Fax | 480-612-0116
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Provider Business Mailing Address
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Address Line | 875 N GREENFIELD RD STE 101
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City | GILBERT
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State | AZ
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Zip | 85234-5044
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Country | US
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Telephone | 480-664-7463
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Fax | 480-612-0116
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA PETERIS
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Credential | CPM
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Telephone | 602-228-9235
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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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