Provider Demographics
NPI:1326820911
Name:SUN VALLEY BIRTH & WELLNESS LLC
Entity Type:Organization
Organization Name:SUN VALLEY BIRTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DESROCHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-608-3444
Mailing Address - Street 1:19580 W INDIAN SCHOOL RD # 105-145
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-2081
Mailing Address - Country:US
Mailing Address - Phone:480-608-3444
Mailing Address - Fax:
Practice Address - Street 1:19580 W INDIAN SCHOOL RD # 105-145
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-2081
Practice Address - Country:US
Practice Address - Phone:480-608-3444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty