Organization
BLACK RIVER BIRTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY KAHOFER (OWNER)
(810) 712-1310
Entity
Organization
Contact information
Practice address
4856 WAGNER RD, CROSWELL, MI 48422-9421
(810) 712-1310
Mailing address
4856 WAGNER RD, CROSWELL, MI 48422-9421
(810) 712-1310
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356047591
NPI
MI
Enumeration date
02/09/2023
Last updated
02/09/2023
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