Provider Demographics
NPI:1407236649
Name:WILD ORCHID BABY, INC
Entity Type:Organization
Organization Name:WILD ORCHID BABY, INC
Other - Org Name:CENTRAL MA DOULA AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:MCKENDRICK
Authorized Official - Last Name:ARVIZU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-792-2229
Mailing Address - Street 1:490 SHREWSBURY ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1607
Mailing Address - Country:US
Mailing Address - Phone:508-792-2229
Mailing Address - Fax:
Practice Address - Street 1:490 SHREWSBURY ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-1607
Practice Address - Country:US
Practice Address - Phone:508-792-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty