Organization
MONTE VISTA CHILD CARE CENTER INC
Active
Other names
Genoa Division
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CLARKE (DIRECTOR OF OPERATIONS)
(909) 624-2774
Entity
Organization
Contact information
Practice address
130 GENOA WAY, UPLAND, CA 91786-6151
(909) 624-2774
(909) 624-6014
Mailing address
9140 MONTE VISTA AVE, MONTCLAIR, CA 91763-1723
(909) 624-2774
(909) 624-6014
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC80305F
—
CA
Enumeration date
02/28/2007
Last updated
08/22/2020
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