Organization
LACTATION VILLAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACY DAVIS IBCLC (EXECUTIVE DIRECTOR/IBCLC)
(313) 920-4914
Entity
Organization
Contact information
Practice address
14210 GLENWOOD ST, DETROIT, MI 48205-2829
(313) 920-4914
(248) 809-9888
Mailing address
14210 GLENWOOD ST, DETROIT, MI 48205-2829
(313) 920-4914
(248) 809-9888
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
L-56572
MI
Other
Enumeration date
04/17/2015
Last updated
04/17/2015
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