=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134016629
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIVING LIGHT HAVEN & BIRTHS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2025
-----------------------------------------------------
Last Update Date | 06/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7123 HUMBLE CT
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77493-7121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-644-6933
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7123 HUMBLE CT
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77493-7121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-644-6933
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO & LEAD DOULA
-----------------------------------------------------
Name | ADETOKUNBO AJAYI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 832-202-6339
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------