NPIMap

Organization Active NPI

Monte Vista Child Care Center Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Upland, CA
National Provider Identifier
1043348238
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
MONTE VISTA CHILD CARE CENTER INC
Practice address
2489 Mesa Terrace Ave
Upland, CA 91786
Phone
(909) 624-2774
Fax
(909) 624-6014
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michelle Clarke
Title
Director of Operations
Phone
(909) 624-2774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

2489 Mesa Terrace Ave
Upland, CA 91786

Mailing address

9140 Monte Vista Ave
Montclair, CA 91763-1723
Phone (909) 624-2774

Other identifiers 1

IdentifierTypeStateIssuer
LTC80247FMedicaidCA

Other names 1

  • Mesa Terrace Division Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G213

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MESA TERRACE DIVISION
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Sep 17, 1998
Last certification
Nov 5, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
2489 Mesa Terrace
Upland, CA 91786

National Provider Directory

National Provider Directory
Tax ID family
Victoria Division19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043348238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9140 MONTE VISTA AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631723",
            "telephone_number": "909-624-2774",
            "fax_number": "909-624-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2489 MESA TERRACE AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-624-2774",
            "fax_number": "909-624-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTE VISTA CHILD CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "909-624-2774"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC80247F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mesa Terrace Division",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.