Provider Demographics
NPI:1457969412
Name:THE LACTATION PLACE, LLC
Entity Type:Organization
Organization Name:THE LACTATION PLACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOUR
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:201-914-0444
Mailing Address - Street 1:51 NEWARK ST STE 404C
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4543
Mailing Address - Country:US
Mailing Address - Phone:201-914-0444
Mailing Address - Fax:201-479-2966
Practice Address - Street 1:51 NEWARK ST STE 404C
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4543
Practice Address - Country:US
Practice Address - Phone:201-657-1727
Practice Address - Fax:201-479-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty