Mountain Shadows Support Group, Inc.

NPI #1003931262 in San Marcos, California

Provider Information

NPI Number
1003931262
Entity Type
Organization
Organization Name
Mountain Shadows Support Group, Inc.
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Mar 20, 2007
Last Updated
Aug 22, 2020

Practice Location

Address
600 ROSE CT
ZIP Code
92069-5828
Phone
(760) 743-3714

Authorized Official

Name
LUPE BRYSON
Title
BUSINESS OFFICE MANAGER
Phone
(760) 743-3714

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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