Provider Demographics
NPI:1518779008
Name:TABOO AWAKENING LLC
Entity type:Organization
Organization Name:TABOO AWAKENING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MA'ISAH
Authorized Official - Middle Name:FATIMA
Authorized Official - Last Name:JONES-NAMBE'
Authorized Official - Suffix:
Authorized Official - Credentials:CPD
Authorized Official - Phone:720-422-7911
Mailing Address - Street 1:1490 ZENOBIA ST APT 403
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-1076
Mailing Address - Country:US
Mailing Address - Phone:720-422-7911
Mailing Address - Fax:
Practice Address - Street 1:1490 ZENOBIA ST APT 403
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1076
Practice Address - Country:US
Practice Address - Phone:720-422-7911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty