Organization Name: | BUNDLE OF JOY BIRTH & WELLNESS CENTER |
NPI Number: | 1093113342 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEISHA T. WILLIAMS (CLINICAL DIRECTOR) |
Mailing Address: | 910 S 8th St Suite 100 Fernandina Beach |
State: | FL US |
Postal Code: | 320343744 |
Phone Number: | 9045147507 |
Fax Number: | |
NPI Enumeration Date: | 12/17/2014 |
NPI Last Update Date: | 12/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QB0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Birthing |
Taxonomy Definition: |