NPIMap

Organization Active NPI

GHC of Upland SNF, LLC

Doing business as Heritage Park Nursing Center

  • Skilled Nursing Facility
  • Upland, CA
National Provider Identifier
1770768509
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
240000465 Issued in CA
Legal business name
GHC OF UPLAND SNF, LLC
Doing business as
Heritage Park Nursing Center
Practice address
275 Garnet Way
Upland, CA 91786-5932
Phone
(909) 949-4887
Fax
(909) 949-8761
NPI assigned
Dec 28, 2007
Last updated
Sep 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Authorized official

Name
Lois A Mastrocola
Title
Chief Financial Officer
Phone
(714) 241-5600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 240000465 CA Primary

Addresses

Primary practice location

275 Garnet Way
Upland, CA 91786-5932

Mailing address

275 Garnet Way
Upland, CA 91786-5932
Phone (909) 949-4887

Other identifiers 1

IdentifierTypeStateIssuer
LTC55514FMedicaidCA

Other names 1

  • Heritage Park Nursing Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071008000092 CA Part A Provider - Skilled Nursing Facility 9830284793 Practice locations: Upland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770768509. Details of each certification follow.

Skilled nursing facility certification: CCN 555514

Legal name
GHC OF UPLAND SNF, LLC
Doing business as
HERITAGE PARK NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 10, 1992
Last certification
May 16, 2024
Beds
70
Ownership / control type
Corporation
Multi-facility organization
Generations Healthcare
Organization structure
LLCProprietary
Incorporated
Jan 4, 2005 in CA
Enrollment address
275 Garnet Way
Upland, CA 91786-5932
Nursing home name
HERITAGE PARK NURSING CENTER
Affiliated entity
GENERATIONS HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Heritage Park Nursing CenterCCN 555514 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 10, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7067.0 residents per day on average
Chain
Generations Healthcare27 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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
05D0564889GHC of Upland SNF LLC Dba Heritage Park Nursing275 Garnet Way a, Upland, CA 91786Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Lois a Mastrocola Individual 5% Or Greater Indirect Ownership InterestChief Financial Officer Feb 1, 1998 9.18%
Corporate OfficerChief Financial Officer Feb 1, 1998
Corporate DirectorChief Financial Officer Feb 1, 1998
W-2 Managing Employee Sep 20, 2023
Thomas Olds Individual 5% Or Greater Indirect Ownership InterestCeo/President Feb 1, 1998 78.13%
Corporate OfficerCeo/President Feb 1, 1998
Corporate DirectorCeo/President Feb 1, 1998
Fred Smith Individual 5% Or Greater Indirect Ownership Interest Feb 1, 1998 12.69%
Life Generations Healthcare, LLC Organization, Santa Ana, CA LLC, For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2005 100%
Bmo Bank National Association Organization, Chicago, IL Financial institution 5% Or Greater Security Interest Sep 20, 2023

Facilities with the same owner 27

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

View all 27

Practitioners & affiliated clinicians

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1770768509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 GARNET WAY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865932",
            "telephone_number": "909-949-4887",
            "fax_number": "909-949-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 GARNET WAY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865932",
            "telephone_number": "909-949-4887",
            "fax_number": "909-949-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHC OF UPLAND SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "MASTROCOLA",
        "authorized_official_first_name": "LOIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "714-241-5600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "240000465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55514F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Heritage Park Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Park Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.