Mountain Shadows Support Group, Inc.
NPI #1215061767 in Moreno Valley, California
Provider Information
- NPI Number
- 1215061767
- Entity Type
- Organization
- Organization Name
- Mountain Shadows Support Group, Inc.
- Primary Specialty
- Nursing Facility/Intermediate Care Facility
- Enumeration Date
- Mar 15, 2007
- Last Updated
- Dec 26, 2007
Practice Location
- Address
- 25654 SIERRA LEONE CT
- City
- Moreno Valley
- State
- California
- ZIP Code
- 92551-2100
- Phone
- (760) 743-3714
Authorized Official
- Name
- MRS. LUPE BRYSON
- Title
- BUSINESS OFFICE MANAGER
- Phone
- (760) 743-3714
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nursing Facility/Intermediate Care Facility |
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