Provider Demographics
NPI:1992375166
Name:COMMUNITY DOULAS OF SOUTH JERSEY
Entity Type:Organization
Organization Name:COMMUNITY DOULAS OF SOUTH JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA TRAINER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPD
Authorized Official - Phone:856-419-3690
Mailing Address - Street 1:49 ARROWWOOD CT
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2950
Mailing Address - Country:US
Mailing Address - Phone:856-419-3690
Mailing Address - Fax:
Practice Address - Street 1:808 MARKET ST FL 2
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08102-1159
Practice Address - Country:US
Practice Address - Phone:800-611-8326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty