Provider Demographics
NPI:1366699852
Name:MOUNTAIN RIGHT TO LIFE
Entity type:Organization
Organization Name:MOUNTAIN RIGHT TO LIFE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:STIEFKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-382-4550
Mailing Address - Street 1:114 E AIRPORT DR STE 104
Mailing Address - Street 2:P.O. BOX 11225, SAN BERNARDINO, CA 92423
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3420
Mailing Address - Country:US
Mailing Address - Phone:909-382-4550
Mailing Address - Fax:909-382-4551
Practice Address - Street 1:114 E AIRPORT DR STE 104
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3420
Practice Address - Country:US
Practice Address - Phone:909-382-4550
Practice Address - Fax:909-382-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240000750251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable