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General NPI Number Information
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NPI Number | 1124807896
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Entity Type | Organization
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Legal Business Name | MAIDEN'S EMBRACE ABA
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 10985 PACIFIC POINT PL UNIT 1203
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City | SAN DIEGO
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State | CA
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Zip | 92129-2088
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Country | US
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Telephone | 858-253-0809
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Fax | 858-261-0057
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Provider Business Mailing Address
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Address Line | 10985 PACIFIC POINT PL UNIT 1203
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City | SAN DIEGO
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State | CA
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Zip | 92129-2088
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Country | US
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Telephone | 858-253-0809
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | IFAH S GRADY
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Credential | BCBA
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Telephone | 858-253-0809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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