Provider Demographics
NPI:1275297756
Name:TENNESSEE VALLEY LACTATION SUPPORT, LLC
Entity Type:Organization
Organization Name:TENNESSEE VALLEY LACTATION SUPPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRESKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-867-2852
Mailing Address - Street 1:984 BEAVER DAM ROAD
Mailing Address - Street 2:
Mailing Address - City:TONEY
Mailing Address - State:AL
Mailing Address - Zip Code:35773
Mailing Address - Country:US
Mailing Address - Phone:518-867-2852
Mailing Address - Fax:256-542-1962
Practice Address - Street 1:984 BEAVER DAM ROAD
Practice Address - Street 2:
Practice Address - City:TONEY
Practice Address - State:AL
Practice Address - Zip Code:35773
Practice Address - Country:US
Practice Address - Phone:518-867-2852
Practice Address - Fax:256-542-1962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty