Provider Demographics
NPI:1235830449
Name:MAKING LIFE WONDERFUL (MLW), INC
Entity Type:Organization
Organization Name:MAKING LIFE WONDERFUL (MLW), INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:909-201-6169
Mailing Address - Street 1:5558 CAPELLA PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-2279
Mailing Address - Country:US
Mailing Address - Phone:909-500-1299
Mailing Address - Fax:951-319-4206
Practice Address - Street 1:5558 CAPELLA PL
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-2279
Practice Address - Country:US
Practice Address - Phone:909-500-1299
Practice Address - Fax:951-319-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No347C00000XTransportation ServicesPrivate Vehicle