Mountain Shadows Support Group, Inc. in Escondido - Intermediate Care Facility, Intellectual Disabilities

Mountain Shadows Support Group, Inc. - NPI 1750406914

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 1750406914. 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 1750406914
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
LTC60197H CA --

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FAQs about Mountain Shadows Support Group, Inc.

What is the Mountain Shadows Support Group, Inc.'s 1750406914?

The Mountain Shadows Support Group, Inc.'s NPI (National Provider Identifier) Number is 1750406914. 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 1750406914 assignment from the Centers for Medicare & Medicaid Services?

The Mountain Shadows Support Group, Inc. was assigned its 1750406914 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.

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