Healthcare Provider Details

I. General information

NPI: 1245044031
Provider Name (Legal Business Name): PUAH PERINATAL PROMISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BELDEN ST
LAKE CHARLES LA
70601-3106
US

IV. Provider business mailing address

433 BAGDAD RD
WESTLAKE LA
70669-3503
US

V. Phone/Fax

Practice location:
  • Phone: 209-346-2895
  • Fax:
Mailing address:
  • Phone: 209-346-2895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTIAN MITCHELL
Title or Position: OWNER/DOULA
Credential:
Phone: 337-502-8108