Provider Demographics
NPI:1558812479
Name:ACORN COMMUNITY BIRTH AND WELLNESS CENTER
Entity Type:Organization
Organization Name:ACORN COMMUNITY BIRTH AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LM CPM
Authorized Official - Phone:760-645-3447
Mailing Address - Street 1:577 E ELDER ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-3079
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:577 E ELDER ST
Practice Address - Street 2:SUITE H
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3079
Practice Address - Country:US
Practice Address - Phone:760-645-3447
Practice Address - Fax:951-200-4396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM429176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty