Provider Demographics
NPI:1679274047
Name:MAMA LEONAS PERINATAL CARE
Entity type:Organization
Organization Name:MAMA LEONAS PERINATAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:MS
Authorized Official - First Name:LEONA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CPD
Authorized Official - Phone:401-548-1584
Mailing Address - Street 1:67 KENYON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-1436
Mailing Address - Country:US
Mailing Address - Phone:401-548-1584
Mailing Address - Fax:
Practice Address - Street 1:67 KENYON ST APT 1
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-1436
Practice Address - Country:US
Practice Address - Phone:401-548-1584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty