MEDICARE: SOUTHERN RI DOULA POSTPARTUM AND NEWBORN CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

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

Provider Business Mailing Address
First Line	:	118 POND ST
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4035
Country	:	US
Telephone Number	:	401-263-5488
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 POND ST
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-4035
Country	:	US
Telephone Number	:	401-263-5488
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DOULA
Name	:	STACEY LEE GREENE BODZIONY
Credential	:	CPD
Telephone Number	:	401-263-5488

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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