Provider Demographics
NPI:1306596531
Name:MATERNITY TOWN
Entity type:Organization
Organization Name:MATERNITY TOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEHRMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-653-2689
Mailing Address - Street 1:5427 SW 78TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4417
Mailing Address - Country:US
Mailing Address - Phone:347-653-2689
Mailing Address - Fax:
Practice Address - Street 1:5427 SW 78TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-4417
Practice Address - Country:US
Practice Address - Phone:347-653-2689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care