Mountain Shadows Support Group, INC
Nursing Facility/Intermediate Care Facility in Moreno Valley, CA. Organization (NPI-2).
NPI number1700901931
StatusActive
Last updated in NPPESDec 26, 2007
Details
- NPI
- 1700901931
- Entity type
- Organization (NPI-2)
- Legal business name
- Mountain Shadows Support Group, INC
- Organization subpart
- No
- Enumeration date
- Mar 20, 2007
- Last updated
- Dec 26, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 313M00000X | Nursing Facility/Intermediate Care Facility | 46989489 | CA | Yes |
Other names
- Special Kids Homes-Lindley Lane (Doing Business As)
Practice location
11315 Lindley LnMoreno Valley, CA 92555-5285
Phone 760-743-3714 · Fax 760-743-9937
Mailing address
2067 W El Norte PkwyEscondido, CA 92026-1810
Phone 760-743-3714 · Fax 760-743-9937
Authorized official
Lupe Bryson
Business Office Manager
7607433714
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All 6 Nursing Facility/Intermediate Care Facility providers in Moreno Valley · All 3,435 providers in Moreno Valley
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