Provider Demographics
NPI:1407563570
Name:HAVEN MIDWIFERY AND BIRTH CENTER
Entity Type:Organization
Organization Name:HAVEN MIDWIFERY AND BIRTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BELISLE
Authorized Official - Suffix:
Authorized Official - Credentials:CDM, CPM
Authorized Official - Phone:907-444-3027
Mailing Address - Street 1:4050 LAKE OTIS PKWY STE 111
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5224
Mailing Address - Country:US
Mailing Address - Phone:907-444-3027
Mailing Address - Fax:844-621-5905
Practice Address - Street 1:6930 E LOWER MESA DR
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7711
Practice Address - Country:US
Practice Address - Phone:907-444-3027
Practice Address - Fax:844-621-5905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty