Mountain Shadows Support Group in Escondido - Intermediate Care Facility, Intellectual Disabilities
Mountain Shadows Support Group - NPI 1396894291
Mountain Shadows Support Group is a Intermediate Care Facility, Intellectual Disabilities in Escondido, California. Mountain Shadows Support Group practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. 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 | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | LTC60136I |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| LTC60136I | CA | -- |
Post Comment/ Review Below
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 Intermediate Care Facility, Intellectual Disabilities, and the corresponding taxonomy code that categorizes this area of expertise is 315P00000X.
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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