Provider Demographics
NPI:1558180737
Name:CLOVER BLOSSOM DOULA CARE LLC
Entity type:Organization
Organization Name:CLOVER BLOSSOM DOULA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLEKSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLUSKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-330-9796
Mailing Address - Street 1:5629 N SUTHERLIN ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-7550
Mailing Address - Country:US
Mailing Address - Phone:714-330-9796
Mailing Address - Fax:
Practice Address - Street 1:5629 N SUTHERLIN ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-7550
Practice Address - Country:US
Practice Address - Phone:714-330-9796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty