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General NPI Number Information
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NPI Number | 1609688399
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Entity Type | Organization
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Legal Business Name | THE GRACE INTERNATIONAL LACTATION CENTER INC
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 1 MAIN ST
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City | TERRYVILLE
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State | CT
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Zip | 06786-5100
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Country | US
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Telephone | 860-620-7087
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Fax |
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Provider Business Mailing Address
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Address Line | 130 SKYLINE DR
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City | SOUTHINGTON
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State | CT
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Zip | 06489-3317
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Country | US
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Telephone | 860-620-7087
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LAURA FERRARO WHITE
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Credential | RN, BSN, IBCLC
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Telephone | 860-620-7087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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