Provider Demographics
NPI:1952058976
Name:CENTRAL ALABAMA LACTATION SERVICES, LLC
Entity Type:Organization
Organization Name:CENTRAL ALABAMA LACTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LACTATION CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:HENDERSON
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:205-902-1468
Mailing Address - Street 1:8298 WADE RD
Mailing Address - Street 2:
Mailing Address - City:WARRIOR
Mailing Address - State:AL
Mailing Address - Zip Code:35180-3016
Mailing Address - Country:US
Mailing Address - Phone:205-902-1468
Mailing Address - Fax:205-378-3886
Practice Address - Street 1:8298 WADE RD
Practice Address - Street 2:
Practice Address - City:WARRIOR
Practice Address - State:AL
Practice Address - Zip Code:35180-3016
Practice Address - Country:US
Practice Address - Phone:205-902-1468
Practice Address - Fax:205-378-3886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty