Organization Active NPI

Lark Spring Terrace Incorporated

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Diamond Bar, CA
National Provider Identifier
1164669446
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
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

Updated by the provider on Apr 17, 2024

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)CodeLicenseStatePrimary
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 NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2053221Lark Spring Terrace, Inc.22504 Lark Spring Terrace, Diamond Bar, CA 91765Certificate of waiverJan 27, 2027

National Provider Directory

National Provider Directory

NPI 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

Verify at the official NPI Registry.