# COLLECTIVE MIDWIFERY CARE LLC

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

## Provider details

- **NPI number:** 1871239822
- **Authorized official:** MRS. KASEY DIVINE CNM (MIDWIFE, PARTNER)
- **Authorized official phone:** (201) 230-4464

## Contact information

- **Practice address:** 408 MAIN ST STE 401A, BOONTON, NJ 07005-1732
- **Practice address phone:** (201) 230-4464
- **Practice address fax:** (866) 715-8797
- **Mailing address:** 408 MAIN ST STE 401A, BOONTON, NJ 07005-1732
- **Mailing address fax:** (866) 715-8797

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 176B00000X | Midwife | — | NULL | Yes |
| 176B00000X | Midwife | — | — | Yes |

## Other

- **Enumeration date:** 05/11/2022
- **Last updated:** 05/11/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 25ME00075701 | BOARD OF MEDICAL EXAMINERS | NJ |
| 01 | — | 25MW00003700 | OFFICE OF CONSUMER AFFAIRS | NJ |