Organization
LACTATION CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA CHRISTOPHER IBCLC (CEO)
(203) 512-7000
Entity
Organization
Contact information
Practice address
1256 W LAKEWOOD BLVD, HOLLAND, MI 49424-6221
(917) 336-7013
(855) 827-6054
Mailing address
1256 W LAKEWOOD BLVD, HOLLAND, MI 49424-6221
(917) 336-7013
(855) 827-6054
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/26/2026
Last updated
03/06/2026
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