MONTE NIDO LAKE VISTA, LLC
NPI 1053934984
Community Based Residential Treatment Facility, Mental Illness in Lafayette, CA

Q: What is Monte Nido Lake Vista, LLC's NPI number?

The NPI number for Monte Nido Lake Vista, LLC is 1053934984. It was assigned to this organization in the NPPES registry on May 27, 2020. The provider is doing business as Monte Nido East Bay.

Q: What is Monte Nido Lake Vista, LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

Active since May 27, 2020CLIA 05D2196626 · Waiver

1776 IVANHOE AVE, LAFAYETTE, CA 94549(305) 663-1876(786) 359-4485 Get Directions Write a Review

NPPES record last updated: May 27, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Monte Nido Lake Vista, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MONTE NIDO LAKE VISTA, LLC (NPI 1053934984), doing business as Monte Nido East Bay, is a healthcare organization registered as a community based residential treatment facility, mental illness in Lafayette, California and active in the NPI registry since May 2020. The organization holds a CLIA Waiver certificate valid through October 18, 2026 and lists Mike Bagley, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1053934984

Entity TypeOrganization

Primary Taxonomy320800000X

Legal Business NameMONTE NIDO LAKE VISTA, LLC

Location Address1776 IVANHOE AVELafayette, CA 94549-1954

Mailing Address6100 Sw 76th StSouth Miami, FL 33143-5002 · (305) 663-1876 · Fax (305) 663-1876

Phone(305) 663-1876

Fax(786) 359-4485

Organization SubpartYes

Authorized OfficialMike BagleyChief Financial Officer · (305) 663-1876

Enumeration DateMay 27, 2020

NPPES CertifiedMay 27, 2020

✔ NPI 1053934984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities

Taxonomy Code320800000X

Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

1776 IVANHOE AVE, Lafayette, CA 94549

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Other Names 1

Doing Business AsMonte Nido East Bay

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2196626

Monte Nido Lake Vista LLC Dba Monte Nido East Bay · Lafayette, CA

Active · expires Oct 18, 2026

CLIA Number05D2196626

Laboratory TypeRes Mental Hlth Facility

Certificate Effective DateOctober 19, 2024

Certificate Expiration DateOctober 18, 2026

Laboratory DirectorMolly M. Perlman

Laboratory Phone(925) 660-0755

Laboratory LocationMonte Nido Lake Vista LLC Dba Monte Nido East Bay1776 Ivanhoe Ave, Lafayette, CA 94549

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Monte Nido Lake Vista, LLC's NPI number?

The NPI number for Monte Nido Lake Vista, LLC is 1053934984. It was assigned to this organization in the NPPES registry on May 27, 2020. The provider is doing business as Monte Nido East Bay.

Where is Monte Nido Lake Vista, LLC located?

Monte Nido Lake Vista, LLC is located at 1776 Ivanhoe Ave, Lafayette, CA 94549. The listed phone number is (305) 663-1876.

What is Monte Nido Lake Vista, LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

Does Monte Nido Lake Vista, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2196626) is associated with this NPI, valid through October 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Monte Nido Lake Vista, LLC was last updated on May 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.