Provider Demographics
NPI:1477763589
Name:LACTATION INSTITUTE
Entity Type:Organization
Organization Name:LACTATION INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHELL
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:818-995-7442
Mailing Address - Street 1:3441 CLAIRTON PL
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4137
Mailing Address - Country:US
Mailing Address - Phone:818-995-7442
Mailing Address - Fax:818-995-0634
Practice Address - Street 1:568 N GREENCRAIG RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-2842
Practice Address - Country:US
Practice Address - Phone:310-476-1404
Practice Address - Fax:310-476-1404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies