Provider Demographics
NPI:1841884145
Name:BIRTH DETROIT CARE
Entity type:Organization
Organization Name:BIRTH DETROIT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHAR'LY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-977-0962
Mailing Address - Street 1:PO BOX 19727
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8575 HERITAGE PL
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48204-2326
Practice Address - Country:US
Practice Address - Phone:313-977-0962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIRTH DETROIT INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-26
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty