Mountain Shadows Support Group, Inc.
NPI #1235254582 in San Marcos, California
Provider Information
- NPI Number
- 1235254582
- Entity Type
- Organization
- Organization Name
- Mountain Shadows Support Group, Inc.
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Mar 19, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 866 VIKING LN
- City
- San Marcos
- State
- California
- ZIP Code
- 92069-5806
- 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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