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General NPI Number Information
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NPI Number | 1609312867
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Entity Type | Organization
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Legal Business Name | SEACOAST LACTATION SERVICES
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Dates
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Enumeration Date | 01/12/2017
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Last Update Date | 01/12/2017
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Provider Practice Location Address
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Address Line | 436 NEWINGTON RD
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City | NEWINGTON
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State | NH
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Zip | 03801-2730
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Country | US
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Telephone | 508-280-8371
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Fax |
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Provider Business Mailing Address
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Address Line | 436 NEWINGTON RD
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City | NEWINGTON
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State | NH
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Zip | 03801-2730
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Country | US
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Telephone | 508-280-8371
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MRS. LAURA LEE STONE
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Credential | RN
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Telephone | 508-280-8371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 051078-21
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License Number State | NY
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