Provider Demographics
NPI:1639522634
Name:HOME CARE LACTATION LLC
Entity Type:Organization
Organization Name:HOME CARE LACTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ANELLO NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LICSW IBCLC
Authorized Official - Phone:978-295-1805
Mailing Address - Street 1:1 BRUNO WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01966-1270
Mailing Address - Country:US
Mailing Address - Phone:978-295-1805
Mailing Address - Fax:
Practice Address - Street 1:1 BRUNO WAY
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:MA
Practice Address - Zip Code:01966-1270
Practice Address - Country:US
Practice Address - Phone:978-295-1805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL22800253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care