# DIVINITY BIRTH SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841697992
- **Authorized official:** MISS DANIELLE K HAUGE CPM, LM (OWNER, LICENSED MIDWIFE)
- **Authorized official phone:** (608) 469-1879

## Contact information

- **Practice address:** 3074 OAK ST, COTTAGE GROVE, WI 53527-9511
- **Practice address phone:** (608) 469-1879
- **Mailing address:** 3074 OAK ST, COTTAGE GROVE, WI 53527-9511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 133-49 | WI | Yes |

## Other

- **Enumeration date:** 12/03/2014
- **Last updated:** 12/03/2014