Provider Demographics
NPI:1831530328
Name:LIL' SEED OF LIFE BIRTH WELLNESS CENTER
Entity type:Organization
Organization Name:LIL' SEED OF LIFE BIRTH WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:CAPOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:AAHCC, CD(DONA)
Authorized Official - Phone:909-468-5828
Mailing Address - Street 1:1349 LINDENGROVE AVE
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2312
Mailing Address - Country:US
Mailing Address - Phone:909-468-5828
Mailing Address - Fax:909-468-5828
Practice Address - Street 1:1349 LINDENGROVE AVE
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2312
Practice Address - Country:US
Practice Address - Phone:909-468-5828
Practice Address - Fax:909-468-5828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty