Provider Demographics
NPI:1922699073
Name:MATRIARCH BIRTH CENTER LLC
Entity Type:Organization
Organization Name:MATRIARCH BIRTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STONEKING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-645-6671
Mailing Address - Street 1:520 N RANGELINE RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1344
Mailing Address - Country:US
Mailing Address - Phone:317-645-6671
Mailing Address - Fax:
Practice Address - Street 1:520 N RANGELINE RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1344
Practice Address - Country:US
Practice Address - Phone:317-645-6671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthingGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty