NPIMap

Organization Active NPI

Beechwood Division

  • Intellectual Disabilities Intermediate Care Facility
  • Rancho Cucamonga, CA
National Provider Identifier
1164558714
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
240000757 Issued in CA
Legal business name
BEECHWOOD DIVISION
Practice address
7976 Beechwood Dr
Rancho Cucamonga, CA 91701-1830
Phone
(909) 899-5046
Fax
(909) 463-2005
NPI assigned
Feb 26, 2007
Organization subpart
Yes
Parent organization
MONTE VISTA CHILD CARE CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Authorized official

Name
Miss Deisy Odett Mendoza
Title
Executive Director
Phone
(909) 912-9314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 240000757 CA Primary

Addresses

Primary practice location

7976 Beechwood Dr
Rancho Cucamonga, CA 91701-1830

Mailing address

13342 Victoria St
Rancho Cucamonga, CA 91739-2020
Phone (909) 899-5046

Other identifiers 8

IdentifierTypeStateIssuer
LTC60980FMedicaidCA
LTC60588FMedicaidCA
LTC60458FMedicaidCA
LTC60943FMedicaidCA
LTC60961FMedicaidCA
LTC60973FMedicaidCA
LTC60734FMedicaidCA
LTC60599FMedicaidCA

Other names 1

  • Beechwood 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 55G801

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
Beechwood Division
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jun 29, 2022
Last certification
Jul 29, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
7976 Beechwood Dr
Rancho Cucamonga, CA 91701

National Provider Directory

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

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1164558714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13342 VICTORIA ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392020",
            "telephone_number": "909-899-5046",
            "fax_number": "909-463-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7976 BEECHWOOD DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917011830",
            "telephone_number": "909-899-5046",
            "fax_number": "909-463-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEECHWOOD DIVISION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTE VISTA CHILD CARE CENTER INC",
        "enumeration_date": "2007-02-26",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "DEISY",
        "authorized_official_middle_name": "ODETT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-912-9314",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "240000757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60980F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60588F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60458F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60943F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60961F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60973F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60734F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60599F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beechwood Division",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.