Organization
MOTHERLY EMBRACE
Active
Organization
MOTHERLY EMBRACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IFAH S GRADY (CEO)
(858) 253-0809
Entity
Organization
Contact information
Practice address
10985 PACIFIC POINT PL UNIT 1203, SAN DIEGO, CA 92129-2088
(858) 253-0809
Mailing address
10985 PACIFIC POINT PL UNIT 1203, SAN DIEGO, CA 92129-2088
(858) 253-0809
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
171000000X
Military Health Care Provider
—
—
174H00000X
Health Educator
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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