Provider Demographics
NPI:1134464225
Name:MAHONING VALLEY BIRTH CENTER LLC
Entity Type:Organization
Organization Name:MAHONING VALLEY BIRTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE-MIDWIFE, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:330-518-7625
Mailing Address - Street 1:3622 BELMONT AVE STE 21
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1444
Mailing Address - Country:US
Mailing Address - Phone:330-406-9929
Mailing Address - Fax:330-758-1141
Practice Address - Street 1:3622 BELMONT AVE STE 21
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1444
Practice Address - Country:US
Practice Address - Phone:330-406-9929
Practice Address - Fax:330-758-1141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing