NPIMap

Organization Active NPI

Upland Community Care, Inc

Doing business as Upland Rehabilitation and Care Center

  • Skilled Nursing Facility
  • Upland, CA
National Provider Identifier
1649351735
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
UPLAND COMMUNITY CARE, INC
Doing business as
Upland Rehabilitation and Care Center
Practice address
1221 East Arrow Hwy
Upland, CA 91786
Phone
(909) 985-1903
NPI assigned
Oct 17, 2006
Last updated
Feb 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1221 East Arrow Hwy
Upland, CA 91786

Mailing address

1221 East Arrow Hwy
Upland, CA 91786
Phone (909) 985-1903

Other identifiers 1

IdentifierTypeStateIssuer
ZZT05374IMedicaidCA

Other names 1

  • Upland Rehabilitation and Care Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050830000596 CA Part A Provider - Skilled Nursing Facility 8224069141 Practice locations: Upland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649351735. Details of each certification follow.

Skilled nursing facility certification: CCN 055374

Legal name
UPLAND COMMUNITY CARE INC
Doing business as
UPLAND REHABILITATION AND CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
May 9, 2025
Beds
206
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Jul 18, 2005 in NV
Enrollment address
1221 E Arrow Hwy
Upland, CA 91786-4911
Nursing home name
UPLAND REHABILITATION AND CARE CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Upland Rehabilitation and Care CenterCCN 055374 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
206182.5 residents per day on average
Chain
The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Flagstone Healthcare Central LLC Organization, Mission Viejo, CA LLC 5% Or Greater Direct Ownership Interest Jun 6, 2005 100%
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation 5% Or Greater Indirect Ownership Interest Jan 30, 2006 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Oct 25, 2002
Adam Willits Individual Corporate DirectorDirector Upland Community Care, Inc Jan 1, 2023
Ami Sato Individual Corporate OfficerTreasurer Upland Community Care Sep 9, 2024
Ctr Partnership LP Organization, San Clemente, CA Adp of the SNF Aug 6, 2005
Caretrust GP LLC Organization, San Clemente, CA LLC Adp of the SNF Aug 6, 2005
Daljinder S Takhar Individual Operational/Managerial Control Jul 29, 2016
Managing Control - Governing BodyMedical Director Jul 29, 2016
Adp of the SNF Jul 9, 2025
Caretrust Reit Inc Organization, San Clemente, CA Corporation Adp of the SNF Aug 6, 2005
Jeremy D Jergensen Individual Corporate OfficerPresident Upland Community Care Jan 1, 2024
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Cedar Avenue Holdings LLC Organization, San Clemente, CA LLC Adp of the SNF Aug 6, 2005
Kip McMillan Individual Operational/Managerial ControlAdministrator Sep 17, 2018
Managing Control - Governing BodyAdministrator Sep 17, 2018
Adp of the SNF Jul 9, 2025
Soon Burnam Individual Corporate OfficerSecretary Upland Community Care Jul 24, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Daljinder Takhar, DO
    • Family Medicine Physician
    • Pomona, CA
    • NPI 1467562249

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Affiliated clinicians 13

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1649351735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 EAST ARROW HWY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-985-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 EAST ARROW HWY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-985-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPLAND COMMUNITY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05374I",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Upland Rehabilitation and Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.