Provider Demographics
NPI:1073718607
Name:MOTHER'S OWN BIRTH AND WOMEN'S CENTER, LLC
Entity Type:Organization
Organization Name:MOTHER'S OWN BIRTH AND WOMEN'S CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:734-847-8100
Mailing Address - Street 1:1715 W DEAN RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-9406
Mailing Address - Country:US
Mailing Address - Phone:734-847-8100
Mailing Address - Fax:734-847-6824
Practice Address - Street 1:1715 W DEAN RD
Practice Address - Street 2:SUITE C
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-9406
Practice Address - Country:US
Practice Address - Phone:734-847-8100
Practice Address - Fax:734-847-6824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing