Provider Demographics
NPI:1528880564
Name:MISSOURI COMMUNITY DOULA COUNCIL
Entity type:Organization
Organization Name:MISSOURI COMMUNITY DOULA COUNCIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LENORE
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-638-0716
Mailing Address - Street 1:2000 E BROADWAY # 109
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6009
Mailing Address - Country:US
Mailing Address - Phone:913-638-0716
Mailing Address - Fax:
Practice Address - Street 1:40 N FLORISSANT RD
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2332
Practice Address - Country:US
Practice Address - Phone:913-638-0716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty