Healthcare Provider Details

I. General information

NPI: 1831691880
Provider Name (Legal Business Name): MCKINLEY CHILDREN'S CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4590 ALLSTATE DR
RIVERSIDE CA
92501-1702
US

IV. Provider business mailing address

4590 ALLSTATE DR
RIVERSIDE CA
92501-1702
US

V. Phone/Fax

Practice location:
  • Phone: 909-599-1227
  • Fax:
Mailing address:
  • Phone: 909-599-1227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ANIL VADAPARTY
Title or Position: CEO
Credential: SPHR, ESQ.
Phone: 909-599-1227