Provider Demographics
NPI:1720406366
Name:FAMILY TREES BIRTH PLACE, LLC
Entity Type:Organization
Organization Name:FAMILY TREES BIRTH PLACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:LOREE
Authorized Official - Last Name:SHIFFER
Authorized Official - Suffix:
Authorized Official - Credentials:CD(DONA), LCCE, BS
Authorized Official - Phone:717-661-7887
Mailing Address - Street 1:2481 NEW HOLLAND PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5953
Mailing Address - Country:US
Mailing Address - Phone:717-661-7887
Mailing Address - Fax:
Practice Address - Street 1:2481 NEW HOLLAND PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-5953
Practice Address - Country:US
Practice Address - Phone:717-661-7887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing