Provider Demographics
NPI:1700145992
Name:RI HOMEBIRTH AND HOPE FAMILY HEALTH
Entity Type:Organization
Organization Name:RI HOMEBIRTH AND HOPE FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:MUMFORD HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:CNM RNP
Authorized Official - Phone:4019-656-8987
Mailing Address - Street 1:104 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:RI
Mailing Address - Zip Code:02831
Mailing Address - Country:US
Mailing Address - Phone:401-965-6897
Mailing Address - Fax:
Practice Address - Street 1:104 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:RI
Practice Address - Zip Code:02831-1837
Practice Address - Country:US
Practice Address - Phone:401-965-6897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI36953364SF0001X
RIMW00103367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Multi-Specialty