Provider Demographics
NPI:1598358236
Name:PERINATAL SUPPORT SERVICES LLC
Entity Type:Organization
Organization Name:PERINATAL SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-365-2415
Mailing Address - Street 1:1714 HAYNES LN
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4721
Mailing Address - Country:US
Mailing Address - Phone:310-365-2415
Mailing Address - Fax:
Practice Address - Street 1:1714 HAYNES LN
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-4721
Practice Address - Country:US
Practice Address - Phone:310-365-2415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty