Provider Demographics
NPI:1396438602
Name:DIVINE PROVIDENCE DOULAS
Entity type:Organization
Organization Name:DIVINE PROVIDENCE DOULAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-536-4281
Mailing Address - Street 1:511 ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-3401
Mailing Address - Country:US
Mailing Address - Phone:401-536-4281
Mailing Address - Fax:
Practice Address - Street 1:511 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-3401
Practice Address - Country:US
Practice Address - Phone:401-536-4281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty