NPI 1215061767
Mountain Shadows Support Group, INC.
Practice location
- Address
- 25654 Sierra Leone CT, Moreno Valley, CA 92551-2100
- Phone
- (760) 743-3714
- Fax
- (760) 743-9937
- Mailing address
- Sheila Marie 2067 W El Norte Pkwy, Escondido, CA 92026-1810
Authorised official
- Name
- Lupe Bryson
- Title
- Business Office Manager
- Phone
- (760) 743-3714
Registered specialties
Nursing Facility/Intermediate Care Facility
Primary
Registry record
- NPI
- 1215061767
- Entity type
- Organization
- NPI issued
- 15 Mar 2007
- Record last updated
- 26 Dec 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.