Provider Demographics
NPI:1447075601
Name:SAN ANTONIO BLACK DOULA COLLECTIVE
Entity type:Organization
Organization Name:SAN ANTONIO BLACK DOULA COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VONBARTHELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-381-4070
Mailing Address - Street 1:830 NORTH BLVD UNIT 2761
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-2331
Mailing Address - Country:US
Mailing Address - Phone:210-381-4070
Mailing Address - Fax:
Practice Address - Street 1:3410 RIDGE RNCH
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-4503
Practice Address - Country:US
Practice Address - Phone:210-381-4070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty