Provider Demographics
NPI:1770027716
Name:THE NEIGHBORHOOD DOULA
Entity Type:Organization
Organization Name:THE NEIGHBORHOOD DOULA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SELF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-497-1215
Mailing Address - Street 1:9312 SEAMILL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-8003
Mailing Address - Country:US
Mailing Address - Phone:704-497-1215
Mailing Address - Fax:
Practice Address - Street 1:9312 SEAMILL RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-8003
Practice Address - Country:US
Practice Address - Phone:704-497-1215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care