Provider Demographics
NPI:1053286013
Name:HEIRLOOM LACTATION, LLC
Entity type:Organization
Organization Name:HEIRLOOM LACTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:925-989-9748
Mailing Address - Street 1:96 TURNER HILL RD
Mailing Address - Street 2:
Mailing Address - City:AVERILL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12018-4020
Mailing Address - Country:US
Mailing Address - Phone:925-989-9748
Mailing Address - Fax:518-650-1914
Practice Address - Street 1:96 TURNER HILL RD
Practice Address - Street 2:
Practice Address - City:AVERILL PARK
Practice Address - State:NY
Practice Address - Zip Code:12018-4020
Practice Address - Country:US
Practice Address - Phone:925-989-9748
Practice Address - Fax:518-650-1914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty