Provider Demographics
NPI:1538459136
Name:GROWING FAMILIY BIRTH CENTER, LLC
Entity Type:Organization
Organization Name:GROWING FAMILIY BIRTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COWART
Authorized Official - Suffix:
Authorized Official - Credentials:CPM, LDM
Authorized Official - Phone:541-259-2500
Mailing Address - Street 1:1300 E GRANT ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-9485
Mailing Address - Country:US
Mailing Address - Phone:541-259-2500
Mailing Address - Fax:541-259-2510
Practice Address - Street 1:1300 E GRANT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-9485
Practice Address - Country:US
Practice Address - Phone:541-259-2500
Practice Address - Fax:541-259-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR071613261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing