Provider Demographics
NPI:1770964215
Name:THE RETREAT MATERNITY SERVICES, LLC
Entity type:Organization
Organization Name:THE RETREAT MATERNITY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:915-449-1025
Mailing Address - Street 1:1312 E RIO GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4815
Mailing Address - Country:US
Mailing Address - Phone:915-308-5000
Mailing Address - Fax:915-603-4411
Practice Address - Street 1:1312 E RIO GRANDE AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4815
Practice Address - Country:US
Practice Address - Phone:915-308-5000
Practice Address - Fax:915-603-4411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing