NPI 1407971633

Mountain Shadows Support Group, INC.

Organisation Nursing Facility/Intermediate Care Facility Riverside, CA

Practice location

Address: 7456 River Glen Dr, Riverside, CA 92509-3451
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

Nursing Facility/Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 313M00000X Licence 46989489 (CA)

Other Nursing Facility/Intermediate Care Facility providers in California →

Registry record

NPI: 1407971633
Entity type: Organization
NPI issued: 20 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.