Mountain Shadows Support Group, Inc. in Escondido - Intermediate Care Facility, Intellectual Disabilities
Mountain Shadows Support Group, Inc. - NPI 1720103971
Mountain Shadows Support Group, Inc. is a Intermediate Care Facility, Intellectual Disabilities in Escondido, California. Mountain Shadows Support Group, Inc. practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. The NPI Number for Mountain Shadows Support Group, Inc. is 1720103971. The last update date is 2020-08-22.
Mountain Shadows Support Group, Inc.'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, Inc. 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, Inc. |
|---|---|
| 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 | 1720103971 |
|---|---|
| Provider Enumeration Date | 2007-03-20 |
| Last Updated Date | 2020-08-22 |
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 | 46989489 |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| LTC60156H | CA | -- |
Post Comment/ Review Below
What is the Mountain Shadows Support Group, Inc.'s 1720103971?
The Mountain Shadows Support Group, Inc.'s NPI (National Provider Identifier) Number is 1720103971. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Mountain Shadows Support Group, Inc. is geographically located?
The Mountain Shadows Support Group, Inc. is physically situated at the following location: 2067 W El Norte Pkwy, Escondido, CA, 920261810.
What is the Mountain Shadows Support Group, Inc.'s area of specialization and corresponding taxonomy classification?
The Mountain Shadows Support Group, Inc.'s specialty field is Intermediate Care Facility, Intellectual Disabilities, and it falls under the taxonomy code 315P00000X, which categorizes healthcare providers based on their specialties.
On what date did Mountain Shadows Support Group, Inc. receive its 1720103971 assignment from the Centers for Medicare & Medicaid Services?
The Mountain Shadows Support Group, Inc. was assigned its 1720103971 on 2007-03-20, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Mountain Shadows Support Group, Inc., such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mountain Shadows Support Group, Inc., including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-08-22.