Provider Demographics
NPI:1508388398
Name:RADIANT TRANSITIONS BIRTH SERVICES LLC
Entity Type:Organization
Organization Name:RADIANT TRANSITIONS BIRTH SERVICES LLC
Other - Org Name:RADIANT TRANSITIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLEGRA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LM CPM IBCLC
Authorized Official - Phone:323-313-2388
Mailing Address - Street 1:3962 1/2 VAN BUREN PL
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2826
Mailing Address - Country:US
Mailing Address - Phone:323-313-2388
Mailing Address - Fax:323-701-0121
Practice Address - Street 1:3962 1/2 VAN BUREN PL
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2826
Practice Address - Country:US
Practice Address - Phone:323-313-2388
Practice Address - Fax:323-701-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-85836174N00000X
CA411176B00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty