Provider Demographics
NPI:1275344798
Name:LIFES CANOPY LLC
Entity type:Organization
Organization Name:LIFES CANOPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CAMPUSANO
Authorized Official - Suffix:
Authorized Official - Credentials:CPE, CPD
Authorized Official - Phone:401-492-8580
Mailing Address - Street 1:101 BENEFIT ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-1024
Mailing Address - Country:US
Mailing Address - Phone:401-492-8580
Mailing Address - Fax:
Practice Address - Street 1:101 BENEFIT ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-1024
Practice Address - Country:US
Practice Address - Phone:401-492-8580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty