Provider Demographics
NPI:1881871960
Name:LABOR OF LOVE BIRTH CENTER
Entity type:Organization
Organization Name:LABOR OF LOVE BIRTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLYNA
Authorized Official - Middle Name:G
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM, RN
Authorized Official - Phone:903-526-2600
Mailing Address - Street 1:417 S CHILTON AVE
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-8017
Mailing Address - Country:US
Mailing Address - Phone:903-526-2600
Mailing Address - Fax:903-526-2605
Practice Address - Street 1:417 S CHILTON AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-8017
Practice Address - Country:US
Practice Address - Phone:903-526-2600
Practice Address - Fax:903-526-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007261261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing