Provider Demographics
NPI:1043391295
Name:MOUNTAIN VIEW BEHAVIORAL HEALTH,INC.
Entity Type:Organization
Organization Name:MOUNTAIN VIEW BEHAVIORAL HEALTH,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KAISER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:909-702-2068
Mailing Address - Street 1:585 N MOUNTAIN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-8516
Mailing Address - Country:US
Mailing Address - Phone:909-931-9988
Mailing Address - Fax:909-931-7311
Practice Address - Street 1:585 N MOUNTAIN AVE STE B
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-8516
Practice Address - Country:US
Practice Address - Phone:909-931-9988
Practice Address - Fax:909-931-7311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty