GRAND TERRACE CARE CENTER
NPI 1811972193
Skilled Nursing Facility in Grand Terrace, CA

Active since December 09, 2005CLIA 05D0702847 · Waiver
12000 MOUNT VERNON AVE, GRAND TERRACE, CA 92313(909) 825-5221 Get Directions Write a Review

NPPES record last updated: April 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 5, 2024, May 27, 2021 (2 updates tracked since 2021).

About Grand Terrace Care Center NPPES

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

GRAND TERRACE CARE CENTER (NPI 1811972193) is a healthcare organization registered as a skilled nursing facility in Grand Terrace, California and active in the NPI registry since December 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Marc Johnson, Cfo, as its authorized official.

NPPES Registry Identity

NPI1811972193
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameGRAND TERRACE HEALTH CARE, INC.
Location Address12000 MOUNT VERNON AVEGrand Terrace, CA 92313-5174
Mailing Address25910 Acero Ste 350Mission Viejo, CA 92691-7908 · (949) 441-9258
Organization SubpartNo
Authorized OfficialMarc JohnsonCfo · (949) 373-8373
Enumeration DateDecember 9, 2005
Last NPPES UpdateApril 5, 20242 updates tracked since enumeration
NPPES CertifiedApril 5, 2024
NPI 1811972193 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in CA · 240000143
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
12000 MOUNT VERNON AVE, Grand Terrace, CA 92313

Other Names 1

Doing Business AsGrand Terrace Care Center

Other Identifiers 1

MedicaidZZT05129JCA

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 05D0702847

Grand Terrace Health Care Center · Grand Terrace, CA
Active · expires Aug 31, 2026
CLIA Number05D0702847
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorAndro Sharobiam
Laboratory Phone(909) 825-5221
Laboratory LocationGrand Terrace Health Care Center12000 Mt Vernon Ave, Grand Terrace, CA 92313
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
12000 MOUNT VERNON AVE
GRAND TERRACE, CA 92313
Skilled Nursing Facility
12000 MOUNT VERNON AVE
GRAND TERRACE, CA 92313
Psychiatry & Neurology (Psychiatry)
12000 MOUNT VERNON AVE
GRAND TERRACE, CA 92313

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 Grand Terrace Health Care, Inc.'s NPI number?

The NPI number for Grand Terrace Health Care, Inc. is 1811972193. It was assigned to this organization in the NPPES registry on December 9, 2005. The provider is doing business as Grand Terrace Care Center.

Where is Grand Terrace Health Care, Inc. located?

Grand Terrace Health Care, Inc. is located at 12000 Mount Vernon Ave, Grand Terrace, CA 92313. The listed phone number is (909) 825-5221.

What is Grand Terrace Health Care, Inc.'s specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Grand Terrace Health Care, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0702847) is associated with this NPI, valid through August 31, 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 Grand Terrace Health Care, Inc. was last updated on April 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.