NPI 1235254582

Mountain Shadows Support Group, INC.

Organisation Intellectual Disabilities Intermediate Care Facility San Marcos, CA

Practice location

Address: 866 Viking Ln, San Marcos, CA 92069-5806
Phone: (760) 743-3714
Fax: (760) 743-9937
Mailing address: 2067 W El Norte Pkwy, Escondido, CA 92026-1810

Authorised official

Name: Lupe Bryson
Title: Business Office Manager
Phone: (760) 743-3714

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 46989489 (CA)

Other Intermediate Care Facility, Intellectual Disabilities providers in California →

Registry record

NPI: 1235254582
Entity type: Organization
NPI issued: 19 Mar 2007
Record last updated: 22 Aug 2020

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.