Provider Demographics
NPI:1710907548
Name:JENNIE JOSEPH FAMILY SERVICES INC.
Entity Type:Organization
Organization Name:JENNIE JOSEPH FAMILY SERVICES INC.
Other - Org Name:THE BIRTH PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR AND MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:407-656-6938
Mailing Address - Street 1:1150 E PLANT ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2922
Mailing Address - Country:US
Mailing Address - Phone:407-656-6938
Mailing Address - Fax:407-656-9161
Practice Address - Street 1:1150 E PLANT ST
Practice Address - Street 2:SUITE F
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2922
Practice Address - Country:US
Practice Address - Phone:407-656-6938
Practice Address - Fax:407-656-9161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL314261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing