Provider Demographics
NPI:1558784678
Name:BE WELL BIRTH WELL BIRTH SERVICES
Entity Type:Organization
Organization Name:BE WELL BIRTH WELL BIRTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LABOR DOULA
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:CLD
Authorized Official - Phone:719-233-4042
Mailing Address - Street 1:20210 PHOEBE GRV
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-1176
Mailing Address - Country:US
Mailing Address - Phone:719-229-3556
Mailing Address - Fax:
Practice Address - Street 1:20210 PHOEBE GRV
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908-1176
Practice Address - Country:US
Practice Address - Phone:719-229-3556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20141054740374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty