Healthcare Provider Details

I. General information

NPI: 1992513774
Provider Name (Legal Business Name): THE BIRTH TRIBE CLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2024
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10621 DUPONT AVE
CLEVELAND OH
44108-1349
US

IV. Provider business mailing address

10621 DUPONT AVE
CLEVELAND OH
44108-1349
US

V. Phone/Fax

Practice location:
  • Phone: 216-392-0942
  • Fax:
Mailing address:
  • Phone: 216-392-0942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State

VIII. Authorized Official

Name: NAKIA SMITH
Title or Position: CEO
Credential: ND, MIDWIFE
Phone: 216-392-0942