NPIMap

Organization Active NPI

Monte Vista Child Care Center Inc

Doing business as Yorktown Division

  • Intellectual Disabilities Intermediate Care Facility
  • Upland, CA
National Provider Identifier
1912035312
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
Yorktown Division
Practice address
315 Yorktown CT
Upland, CA 91784-1640
Phone
(909) 624-2774
Fax
(909) 624-6014
NPI assigned
Feb 28, 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 NU Primary

Addresses

Primary practice location

315 Yorktown CT
Upland, CA 91784-1640

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
LTC80201FMedicaidCA

Other names 1

  • Yorktown 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 1912035312. Details of each certification follow.

  • CCN 55G078 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G078

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
YORKTOWN DIVISION
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Feb 14, 1997
Last certification
May 6, 2025
Beds
6
Ownership / control type
Private (proprietary)
Most recent change of ownership
Apr 28, 2010
Facility address
315 Yorktown
Upland, CA 91784

National Provider Directory

National Provider Directory
Tax ID family
Victoria 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

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": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912035312",
    "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": "315 YORKTOWN CT",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917841640",
            "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": "2007-02-28",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC80201F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yorktown Division",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.