MEDICARE: HALOS HONEY BEE DOULA 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	261QB0400X	Birthing Clinic/Center

General Provider Information

NPI Number	:	1740012285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALOS HONEY BEE DOULA LLC

Provider Business Mailing Address
First Line	:	10907 GRANDVIEW AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3528
Country	:	US
Telephone Number	:	216-307-1472
Fax Number	:

Provider Business Practice Location Address
First Line	:	10907 GRANDVIEW AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3528
Country	:	US
Telephone Number	:	216-307-1472
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	IVORY SIMS
Credential	:
Telephone Number	:	216-307-1472

Provider Enumeration Date	:	08/14/2024
Last Update Date	:	08/14/2024

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