Organization
MATERNAL HOME CHILDBIRTH SERVICES, LLC
Active
Other names
Maternal Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA N DALLES CCC, MHSA (OWNER/CHILDBIRTH CONSULTANT)
(724) 471-8606
Entity
Organization
Contact information
Practice address
366 NEEDLES TRL, LONGWOOD, FL 32779-4655
(724) 471-8606
Mailing address
366 NEEDLES TRL, LONGWOOD, FL 32779-4655
(724) 471-8606
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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