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General NPI Number Information
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NPI Number | 1235830449
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Entity Type | Organization
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Legal Business Name | MAKING LIFE WONDERFUL (MLW), INC
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Dates
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Enumeration Date | 03/14/2023
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 5558 CAPELLA PL
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2279
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Country | US
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Telephone | 909-500-1299
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Fax | 951-319-4206
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Provider Business Mailing Address
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Address Line | 5558 CAPELLA PL
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2279
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Country | US
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Telephone | 909-500-1299
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Fax | 951-319-4206
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MRS. MICHELLE LYNN WHITE
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Credential | REGISTERED NURSE
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Telephone | 909-201-6169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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