Provider Demographics
NPI:1760174445
Name:SHAI DOULA SERVICES LLC
Entity Type:Organization
Organization Name:SHAI DOULA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CAMARIA
Authorized Official - Middle Name:SHAI
Authorized Official - Last Name:WAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-307-9691
Mailing Address - Street 1:17410 MACK AVE # 1207
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48230-6228
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1763 WARWICK AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-1448
Practice Address - Country:US
Practice Address - Phone:734-307-9691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty