Provider Demographics
NPI:1033671565
Name:MOUNTAIN VIEW FAMILY SERVICES
Entity Type:Organization
Organization Name:MOUNTAIN VIEW FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-240-0250
Mailing Address - Street 1:2735 W PEBBLE RD UNIT 510
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-6568
Mailing Address - Country:US
Mailing Address - Phone:510-240-0250
Mailing Address - Fax:
Practice Address - Street 1:2735 W PEBBLE RD UNIT 510
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-6568
Practice Address - Country:US
Practice Address - Phone:510-240-0250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty