Provider Demographics
NPI:1679334668
Name:DOULAS OF THE DIASPORA LLC
Entity type:Organization
Organization Name:DOULAS OF THE DIASPORA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIDEUSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMEIDA
Authorized Official - Suffix:
Authorized Official - Credentials:DRPH
Authorized Official - Phone:617-963-4133
Mailing Address - Street 1:68 HARRISON AVENUE
Mailing Address - Street 2:SUITE 605 #779386
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-963-4133
Mailing Address - Fax:
Practice Address - Street 1:68 HARRISON AVENUE
Practice Address - Street 2:SUITE 605 #779386
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-963-4133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110205929AMedicaid