Provider Demographics
NPI:1205252848
Name:THE BIRTH HAVEN AT LIFESPRING MIDWIFERY
Entity type:Organization
Organization Name:THE BIRTH HAVEN AT LIFESPRING MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:HAASCH
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:480-664-7463
Mailing Address - Street 1:3303 S LINDSAY RD STE 125
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-2100
Mailing Address - Country:US
Mailing Address - Phone:480-664-7463
Mailing Address - Fax:
Practice Address - Street 1:3303 S LINDSAY RD STE 125
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-2100
Practice Address - Country:US
Practice Address - Phone:480-664-7463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFESPRING MIDWIFERY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC5891261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing