Provider Demographics
NPI:1629487004
Name:WEST ORANGE WOMEN'S HEALTH SERVICES
Entity Type:Organization
Organization Name:WEST ORANGE WOMEN'S HEALTH SERVICES
Other - Org Name:THE BIRTH PLACE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:407-656-6938
Mailing Address - Street 1:213 S DILLARD ST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3522
Mailing Address - Country:US
Mailing Address - Phone:407-656-6938
Mailing Address - Fax:407-656-9161
Practice Address - Street 1:213 S DILLARD ST
Practice Address - Street 2:SUITE 340
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3522
Practice Address - Country:US
Practice Address - Phone:407-656-6938
Practice Address - Fax:407-656-9161
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMONSENSE CHILDBIRTH INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-11
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X, 133V00000X, 171M00000X, 172V00000X, 174H00000X, 174N00000X, 374J00000X
FL743652163W00000X
FLMW0053176B00000X
FLTMW8176B00000X
FLMW310176B00000X
FLME96125207V00000X
FL1967452367A00000X
FL9327743367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014091700Medicaid