Provider Demographics
NPI:1407647704
Name:AWAKENING TRADITIONS
Entity type:Organization
Organization Name:AWAKENING TRADITIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGING MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:LAURIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KEYS
Authorized Official - Suffix:
Authorized Official - Credentials:DEM
Authorized Official - Phone:860-985-4891
Mailing Address - Street 1:12 CHARTER OAK PL
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 CHARTER OAK PL
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5116
Practice Address - Country:US
Practice Address - Phone:860-985-4891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health