Provider Demographics
NPI:1932609385
Name:VEGAS VALLEY LACTATION SERVICES LLC
Entity Type:Organization
Organization Name:VEGAS VALLEY LACTATION SERVICES LLC
Other - Org Name:VEGAS VALLEY LACTATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ LACTATION CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALURA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-483-1666
Mailing Address - Street 1:2551 WILLIAMSBURG ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4932
Mailing Address - Country:US
Mailing Address - Phone:702-483-1666
Mailing Address - Fax:
Practice Address - Street 1:1481 W WARM SPRINGS RD STE 136
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7636
Practice Address - Country:US
Practice Address - Phone:702-483-1666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty