Healthcare Provider Details

I. General information

NPI: 1003133695
Provider Name (Legal Business Name): MOUNTAIN VIEW CHILD CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 01/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 MOUNTAIN VIEW AVE
LOMA LINDA CA
92354-1727
US

IV. Provider business mailing address

1720 MOUNTAIN VIEW AVE
LOMA LINDA CA
92354-1727
US

V. Phone/Fax

Practice location:
  • Phone: 909-796-6915
  • Fax: 909-796-4365
Mailing address:
  • Phone: 909-796-6915
  • Fax: 909-796-4365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number550002720
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number550002720
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number550002720
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code283XC2000X
TaxonomyChildren's Rehabilitation Hospital
License Number550002720
License Number StateCA

VIII. Authorized Official

Name: MR. DOUGLAS PADGETT
Title or Position: PRESIDENT
Credential:
Phone: 909-796-6915