Mountain Shadows Support Group in Escondido - Nursing Facility/intermediate Care Facility

Mountain Shadows Support Group - NPI 1396894291

Mountain Shadows Support Group is a Nursing Facility/intermediate Care Facility in Escondido, California. Mountain Shadows Support Group practices all healthcare services and medical treatments related to Nursing Facility/intermediate Care Facility. The NPI Number for Mountain Shadows Support Group is 1396894291. The last update date is 2011-11-09.

Mountain Shadows Support Group's current location address is 2067 W El Norte Pkwy, Escondido, California. You can contact this provider via phone number 7607433714 and fax number 7607439937. The mailing address for Mountain Shadows Support Group is 2067 W El Norte Pkwy, Escondido, California. To know further, please read the information below!

Provider Profile Detail

Provider Organization Mountain Shadows Support Group
Address 2067 W El Norte Pkwy, Escondido, California
Phone Number 7607433714
Fax Number 7607439937
Sole Proprietor --
Credentials --

Authorized Official

Title or Position BUSINESS O
Authorized Official Name Bryson Lupe
Telephone Number 7607433714

NPI Number Detail

NPI Number 1396894291
Provider Enumeration Date 2007-01-09
Last Updated Date 2011-11-09

Provider Mailing Address Detail

Address 2067 W El Norte Pkwy
City Escondido
State California (CA)
Post Code 920261810
Phone Number 7607433714
Fax Number 7607439937

Provider's Primary Taxonomy Detail

Speciality Nursing Facility/intermediate Care Facility
Taxonomy 313M00000X
Licence No 90000253
Definition:
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the reha

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
LTC60136I CA --

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FAQs about Mountain Shadows Support Group

What is the unique 10-digit identification code issued to Mountain Shadows Support Group by the Centers for Medicare & Medicaid Services?

The Mountain Shadows Support Group has been assigned the NPI (National Provider Identifier) 1396894291 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.

Could you share the physical location details of Mountain Shadows Support Group?

The Mountain Shadows Support Group is situated at 2067 W El Norte Pkwy, in the city of Escondido, state of CA, with the zip code 920261810.

What is the area of specialization for Mountain Shadows Support Group, and what is the corresponding taxonomy classification code for this field?

The specialized field of practice for Mountain Shadows Support Group is Nursing Facility/intermediate Care Facility, and the corresponding taxonomy code that categorizes this area of expertise is 313M00000X.

On what date did the Centers for Medicare & Medicaid Services issue the 1396894291 to Mountain Shadows Support Group?

The Mountain Shadows Support Group received its 1396894291 assignment from the Centers for Medicare & Medicaid Services on 2007-01-09.

As of what date were the details related to Mountain Shadows Support Group most recently updated or revised?

The information pertaining to Mountain Shadows Support Group, including its address, specialty, and other relevant details, was last updated or revised on 2011-11-09.

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