Healthcare Provider Details

I. General information

NPI: 1679405120
Provider Name (Legal Business Name): SOUTHERN RI DOULA POSTPARTUM AND NEWBORN CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 POND ST
WAKEFIELD RI
02879-4035
US

IV. Provider business mailing address

118 POND ST
WAKEFIELD RI
02879-4035
US

V. Phone/Fax

Practice location:
  • Phone: 401-263-5488
  • Fax:
Mailing address:
  • Phone: 401-263-5488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: STACEY LEE GREENE BODZIONY
Title or Position: OWNER/DOULA
Credential: CPD
Phone: 401-263-5488