Provider Demographics
NPI:1659937597
Name:JAMAA BIRTH VILLAGE
Entity Type:Organization
Organization Name:JAMAA BIRTH VILLAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE & CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAMPBELL-KELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CD,CPM,CLC
Authorized Official - Phone:314-643-7703
Mailing Address - Street 1:8 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2409
Mailing Address - Country:US
Mailing Address - Phone:314-643-7703
Mailing Address - Fax:314-736-5550
Practice Address - Street 1:8 CHURCH ST
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2409
Practice Address - Country:US
Practice Address - Phone:314-643-7703
Practice Address - Fax:314-736-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthingGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical