Provider Demographics
NPI:1972296903
Name:FRUITS OF LABOR: CHILDBIRTH EDUCATION AND BREASTFEEDING SERVICES LLC
Entity Type:Organization
Organization Name:FRUITS OF LABOR: CHILDBIRTH EDUCATION AND BREASTFEEDING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DESTINY
Authorized Official - Middle Name:OLIVEA
Authorized Official - Last Name:SAUCEDO
Authorized Official - Suffix:
Authorized Official - Credentials:CLC, CCE
Authorized Official - Phone:404-834-3174
Mailing Address - Street 1:304 FREEMAN CIR
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-7085
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:304 FREEMAN CIR
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-7085
Practice Address - Country:US
Practice Address - Phone:404-834-3174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty