Mountain Shadows Support Group

Nursing Facility/Intermediate Care Facility · Escondido, CA

Organization Active NPI

NPI number 1396894291

Practice location

2067 W El Norte Pkwy
Escondido, CA 92026-1810
Phone
(760) 743-3714
Fax
(760) 743-9937

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NPI record

NPI
1396894291
Entity type
Organization (Type 2)
Enumeration date
January 9, 2007
Last updated
November 9, 2011
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nursing Facility/Intermediate Care Facility Primary 313M00000X 090000253 CA
Intellectual Disabilities Intermediate Care Facility 315P00000X LTC60136I CA

Authorized official

Name
Mrs. Lupe Bryson
Title
Business Office Manager
Phone
(760) 743-3714

Other names

  • Mountain Shadows Community Homes-Olive

About Mountain Shadows Support Group

Mountain Shadows Support Group is a healthcare organization registered in the NPI registry with the primary taxonomy Nursing Facility/Intermediate Care Facility (code 313M00000X). The practice location is 2067 W El Norte Pkwy, Escondido, CA 92026-1810. The NPI number 1396894291 was assigned on January 9, 2007 and the record was last updated on November 9, 2011.

Mountain Shadows Support Group lists 2 licenses in the registry: #090000253 (CA) for Nursing Facility/Intermediate Care Facility; #LTC60136I (CA) for Intellectual Disabilities Intermediate Care Facility. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Mrs. Lupe Bryson, Business Office Manager.

Frequently asked questions

What is the NPI number of Mountain Shadows Support Group?

The NPI number is 1396894291.

What is the phone number of Mountain Shadows Support Group?

The phone number listed for the practice location is (760) 743-3714.

Where is Mountain Shadows Support Group located?

2067 W El Norte Pkwy, Escondido, CA 92026-1810.

What is the taxonomy code for Mountain Shadows Support Group?

The primary taxonomy code is 313M00000X – Nursing Facility/Intermediate Care Facility; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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