Provider Demographics
NPI:1003133695
Name:MOUNTAIN VIEW CHILD CARE, INC.
Entity Type:Organization
Organization Name:MOUNTAIN VIEW CHILD CARE, INC.
Other - Org Name:TOTALLY KIDS REHABILITATION HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-796-6915
Mailing Address - Street 1:1720 MOUNTAIN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-1727
Mailing Address - Country:US
Mailing Address - Phone:909-796-6915
Mailing Address - Fax:909-796-4365
Practice Address - Street 1:1720 MOUNTAIN VIEW AVE
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-1727
Practice Address - Country:US
Practice Address - Phone:909-796-6915
Practice Address - Fax:909-796-4365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002720261QR0401X, 282N00000X, 282NC2000X, 283XC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283XC2000XHospitalsRehabilitation HospitalChildren
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No282N00000XHospitalsGeneral Acute Care Hospital
No282NC2000XHospitalsGeneral Acute Care HospitalChildren