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MONTE VISTA CHILD CARE CENTER INC NPI 1295863686


NPI Information

NPI: 1295863686
Provider Name: MONTE VISTA CHILD CARE CENTER INC

Doing Business As: GENOA DIVISION

Classification: Intermediate Care Facility, Mentally Retarded - 315P00000X
Entity Type: Organization
Address:
130 GENOA WAY
UPLAND, CA
ZIP 91786
Phone: (909) 624-2774
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MONTE VISTA CHILD CARE CENTER INC is an intermediate care facility mentally retarded in Upland, CA. The provider is (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. MONTE VISTA CHILD CARE CENTER INC NPI is 1295863686. The provider is registered as an organization entity type.
The provider Is Doing Business As Genoa Division.

The provider's business location address is:

130 GENOA WAY
UPLAND, CA
ZIP 91786-151
Phone: (909) 624-2774
Fax: (909) 624-6014

The provider's authorized official is Michelle Clarke .
The authorized official title is Director Of Operations and has the following contact phone number (909) 624-2774.

The enumeration date for this NPI number is 2/28/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1315P00000XIntermediate Care Facility, Mentally RetardedYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1LTC80305FMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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