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General NPI Number Information
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NPI Number | 1164558714
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Entity Type | Organization
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Legal Business Name | MONTE VISTA CHILD CARE CENTER
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 7976 BEECHWOOD DR
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-1830
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Country | US
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Telephone | 909-899-5046
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Fax | 909-463-2005
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Provider Business Mailing Address
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Address Line | 13342 VICTORIA ST
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2020
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Country | US
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Telephone | 909-899-5046
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Fax | 909-463-2005
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MISS DEISY ODETT MENDOZA
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Credential |
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Telephone | 909-912-9314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 240000757
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License Number State | CA
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