Provider Demographics
NPI:1205247640
Name:THE MOTHER NURTURE CENTER
Entity type:Organization
Organization Name:THE MOTHER NURTURE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-798-9000
Mailing Address - Street 1:105 W TORRANCE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3609
Mailing Address - Country:US
Mailing Address - Phone:310-798-9000
Mailing Address - Fax:
Practice Address - Street 1:105 W TORRANCE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3609
Practice Address - Country:US
Practice Address - Phone:310-798-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty