Provider Demographics
NPI:1821770603
Name:HAZEL RIVER DOULAS LLC
Entity Type:Organization
Organization Name:HAZEL RIVER DOULAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PERINATAL DOULA
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:CPD
Authorized Official - Phone:401-250-2682
Mailing Address - Street 1:25 LELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-5405
Mailing Address - Country:US
Mailing Address - Phone:401-250-2682
Mailing Address - Fax:
Practice Address - Street 1:25 LELAND AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-5405
Practice Address - Country:US
Practice Address - Phone:401-250-2682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing