Provider Demographics
NPI:1669254504
Name:WAVE'S EMBRACE DOULA SERVICES LLC
Entity type:Organization
Organization Name:WAVE'S EMBRACE DOULA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGHTALING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-585-5570
Mailing Address - Street 1:1443 LYONS AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-4123
Mailing Address - Country:US
Mailing Address - Phone:209-585-8610
Mailing Address - Fax:
Practice Address - Street 1:1443 LYONS AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4123
Practice Address - Country:US
Practice Address - Phone:209-585-8610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty