Healthcare Provider Details

I. General information

NPI: 1023311545
Provider Name (Legal Business Name): CEEJAY DOULA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2010
Last Update Date: 03/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 W FLORIDA ST
PERRY FL
32347-1921
US

IV. Provider business mailing address

312 W FLORIDA ST
PERRY FL
32347-1921
US

V. Phone/Fax

Practice location:
  • Phone: 850-251-6427
  • Fax:
Mailing address:
  • Phone: 850-251-6427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number376K00000X
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License NumberCD(DONA)#5294
License Number StateFL

VIII. Authorized Official

Name: MS. LINDA NAOMI DAVIS
Title or Position: MANAGER/OWNER
Credential:
Phone: 850-251-6427