Provider Demographics
NPI:1609688399
Name:THE GRACE INTERNATIONAL LACTATION CENTER INC
Entity type:Organization
Organization Name:THE GRACE INTERNATIONAL LACTATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:FERRARO
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, IBCLC
Authorized Official - Phone:860-620-7087
Mailing Address - Street 1:130 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-3317
Mailing Address - Country:US
Mailing Address - Phone:860-620-7087
Mailing Address - Fax:
Practice Address - Street 1:1 MAIN ST
Practice Address - Street 2:
Practice Address - City:TERRYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06786-5100
Practice Address - Country:US
Practice Address - Phone:860-620-7087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable