Healthcare Provider Details

I. General information

NPI: 1891446399
Provider Name (Legal Business Name): SKILLE THERAPEUTIC AND CHILD DEVELOPMENT CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2022
Last Update Date: 10/01/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8146 GARDEN PARK STREET, CHINO CA 91708
CHINO CA
91708-9347
US

IV. Provider business mailing address

8146 GARDEN PARK STREET, CHINO CA 91708
CHINO CA
91708-9347
US

V. Phone/Fax

Practice location:
  • Phone: 845-300-2785
  • Fax:
Mailing address:
  • Phone: 845-300-2785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAURO HERNANDEZ REYES JR.
Title or Position: OWNER/CFO
Credential: RN, CLS
Phone: 845-300-2785