Active NPI
Lark Spring Terrace Incorporated
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Diamond Bar, CA
National Provider Identifier
1164669446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Legal business name
- LARK SPRING TERRACE INCORPORATED
- Practice address
- 22504 Lark Spring Ter
Diamond Bar, CA 91765-2956 - Phone
- (909) 860-2622
- Fax
- (909) 860-2622
- NPI assigned
- Jan 8, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Lourdes Ofelia Aguinaldo Abarientos
- Title
- Ceo/Cfo/Secretary
- Phone
- (714) 398-6898
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | Primary |
Addresses
Primary practice location
22504 Lark Spring Ter
Diamond Bar, CA 91765-2956
Mailing address
22504 Lark Spring Ter
Diamond Bar, CA 91765-2956
Phone (909) 860-2622
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 55G619
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
- LARK SPRING TERRACE, INC
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Nov 24, 2008
- Last certification
- May 7, 2025
- Beds
- 6
- Ownership / control type
- Other (specify)
- Facility address
- 22504 Lark Spring Terrace
Diamond Bar, CA 91765
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2053221 | Lark Spring Terrace, Inc. | Certificate of waiver | Jan 27, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231372800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713312000000",
"number": "1164669446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22504 LARK SPRING TER",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917652956",
"telephone_number": "909-860-2622",
"fax_number": "909-860-2622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22504 LARK SPRING TER",
"city": "DIAMOND BAR",
"state": "CA",
"postal_code": "917652956",
"telephone_number": "909-860-2622",
"fax_number": "909-860-2622"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LARK SPRING TERRACE INCORPORATED",
"organizational_subpart": "NO",
"enumeration_date": "2009-01-08",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A",
"authorized_official_last_name": "ABARIENTOS",
"authorized_official_first_name": "LOURDES OFELIA",
"authorized_official_middle_name": "AGUINALDO",
"authorized_official_title_or_position": "CEO/CFO/SECRETARY",
"authorized_official_telephone_number": "714-398-6898",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Diamond Bar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.