Healthcare Provider Details

I. General information

NPI: 1174335863
Provider Name (Legal Business Name): EMBRACE BIRTHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CASTLE BRIDGE CT
GREENSBORO NC
27407-6113
US

IV. Provider business mailing address

4 CASTLE BRIDGE CT
GREENSBORO NC
27407-6113
US

V. Phone/Fax

Practice location:
  • Phone: 772-332-7459
  • Fax:
Mailing address:
  • Phone: 772-332-7459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: JAEL HENRY
Title or Position: CEO
Credential:
Phone: 772-332-7459