NPIMap

Organization Active NPI

Ability Pathways Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Sun Valley, CA
National Provider Identifier
1093843088
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
960001328 Issued in CA
Legal business name
ABILITY PATHWAYS INC
Practice address
10528 Crockett St
Sun Valley, CA 91352-2208
Phone
(818) 252-7143
Fax
(909) 981-0296
NPI assigned
Mar 1, 2007
Last updated
Nov 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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

Authorized official

Name
Ms. Michelle ClarkeNPI 1245765791
Title
President
Phone
(909) 240-7680

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X
Intellectual Disabilities Intermediate Care Facility 315P00000X 960001328 CA Primary

Addresses

Primary practice location

10528 Crockett St
Sun Valley, CA 91352-2208

Mailing address

1042 N Mountain Ave B-447
Upland, CA 91786-3695
Phone (909) 982-2991

Other identifiers 1

IdentifierTypeStateIssuer
LTC60981FMedicaidCA

Other names 1

  • Crockett Division Other name

Medicare participation

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093843088. Details of each certification follow.

  • CCN 55G395 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G395

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
CROCKETT DIVISION
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Oct 25, 2001
Last certification
Jun 20, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
10528 Crockett Street
Sun Valley, CA 91352

National Provider Directory

National Provider Directory
Tax ID family
Ability Pathways Incorporated15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1510185600000",
    "number": "1093843088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 N MOUNTAIN AVE B-447",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863695",
            "telephone_number": "909-982-2991",
            "fax_number": "909-981-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10528 CROCKETT ST",
            "city": "SUN VALLEY",
            "state": "CA",
            "postal_code": "913522208",
            "telephone_number": "818-252-7143",
            "fax_number": "909-981-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABILITY PATHWAYS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2017-11-09",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-240-7680",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "960001328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60981F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crockett Division",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sun Valley, CA

Sources for this page

Verify at the official NPI Registry.