NPIMap

Organization Active NPI

Monte Vista Child Care Center Inc

Doing business as Gibbs Division

  • Intellectual Disabilities Intermediate Care Facility
  • Upland, CA
National Provider Identifier
1417085499
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
Doing business as
Gibbs Division
Practice address
1463 N Albright Ave
Upland, CA 91786-2725
Phone
(909) 624-2774
Fax
(909) 624-6014
NPI assigned
Mar 1, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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

1463 N Albright Ave
Upland, CA 91786-2725

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
LTC80306FMedicaidCA

Other names 1

  • Gibbs Division Doing business as

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 1417085499. Details of each certification follow.

  • CCN 55G397 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G397

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
GIBBS DIVISION
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Oct 31, 2001
Last certification
Oct 14, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
1463 Albright Street
Upland, CA 91786

National Provider Directory

National Provider Directory
Tax ID family
Monte Vista Child Care Center Inc19 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, 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": "1598054400000",
    "number": "1417085499",
    "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": "1463 N ALBRIGHT AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862725",
            "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": "LTC80306F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gibbs Division",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.