Provider Demographics
NPI:1033830153
Name:MCKINLEY CHILDREN'S CENTER, INC.
Entity Type:Organization
Organization Name:MCKINLEY CHILDREN'S CENTER, INC.
Other - Org Name:MCKINLEY- PRIVATE PAY
Other - Org Type:Other Name
Authorized Official - Title/Position:AVP OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:909-599-1227
Mailing Address - Street 1:180 VIA VERDE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-3993
Mailing Address - Country:US
Mailing Address - Phone:909-599-1227
Mailing Address - Fax:
Practice Address - Street 1:180 VIA VERDE STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3993
Practice Address - Country:US
Practice Address - Phone:909-599-1227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCKINLEY CHILDREN'S CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-07
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)