Provider Demographics
NPI:1003205758
Name:COURAGEOUS HEART BIRTH SUPPORT LLC
Entity Type:Organization
Organization Name:COURAGEOUS HEART BIRTH SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-895-2408
Mailing Address - Street 1:11212 N DITMAN AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157-1160
Mailing Address - Country:US
Mailing Address - Phone:816-520-0798
Mailing Address - Fax:
Practice Address - Street 1:11212 N DITMAN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64157-1160
Practice Address - Country:US
Practice Address - Phone:816-520-0798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty