Healthcare Provider Details
I. General information
NPI: 1093593113
Provider Name (Legal Business Name): MCKINLEY CHILDREN'S CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/19/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1011 E DEVONSHIRE AVE STE 201
HEMET CA
92543-3033
US
IV. Provider business mailing address
180 VIA VERDE STE 200
SAN DIMAS CA
91773-3993
US
V. Phone/Fax
- Phone: 909-599-1227
- Fax:
- Phone: 909-599-1227
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GABRIELA
RHODES
Title or Position: AVP OF COMPLIANCE
Credential:
Phone: 909-599-1227