NPIMap

Organization Active NPI

Erin House

  • Intellectual Disabilities Intermediate Care Facility
  • Upland, CA
National Provider Identifier
1538514807
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
ERIN HOUSE
Practice address
1303 N Erin Ave
Upland, CA 91786-2661
Phone
(909) 899-5043
Fax
(909) 463-2005
NPI assigned
Apr 25, 2016
Last updated
Jun 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

1303 N Erin Ave
Upland, CA 91786-2661

Mailing address

13342 Victoria St
Rancho Cucamonga, CA 91739-2020
Phone (989) 899-5043

Other identifiers 1

IdentifierTypeStateIssuer
1164558714MedicaidCA

Other names 1

  • Erin 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 1538514807. Details of each certification follow.

  • CCN 55G765 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G765

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
ERIN HOUSE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Mar 9, 2018
Last certification
Apr 15, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
1303 N Erin Avenue
Upland, CA 91786

National Provider Directory

National Provider Directory
Tax ID family
Oaks Division19 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

NPI Registry JSON

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1538514807",
    "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": "989-899-5043",
            "fax_number": "909-463-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 N ERIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862661",
            "telephone_number": "909-899-5043",
            "fax_number": "909-463-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIN HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-25",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "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"
    },
    "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": "1164558714",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Erin Division",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.