Columbine Division
NPI #1649422080 in Montclair, California
Provider Information
- NPI Number
- 1649422080
- Entity Type
- Organization
- Organization Name
- Columbine Division
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MONTE VISTA CHILD CARE CENTER
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Oct 16, 2008
- Last Updated
- Jun 18, 2025
Practice Location
- Address
- 9420 COLUMBINE AVE
- City
- Montclair
- State
- California
- ZIP Code
- 91763-2506
- Phone
- (909) 899-5046
Authorized Official
- Name
- MISS DEISY ODETT MENDOZA
- Title
- EXECUTIVE DIRECTOR
- Phone
- (909) 912-9314
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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