Provider Demographics
NPI:1225198088
Name:HILLVIEW ACRES CHILDREN'S HOME
Entity Type:Organization
Organization Name:HILLVIEW ACRES CHILDREN'S HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STORM
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:909-993-5555
Mailing Address - Street 1:3683 CHINO AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4719
Mailing Address - Country:US
Mailing Address - Phone:909-628-1272
Mailing Address - Fax:909-627-1906
Practice Address - Street 1:3683 CHINO AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4719
Practice Address - Country:US
Practice Address - Phone:909-628-1272
Practice Address - Fax:909-627-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children