Mountain Shadows Support Group

NPI #1326430711 in Jurupa Valley, California

Provider Information

NPI Number
1326430711
Entity Type
Organization
Organization Name
Mountain Shadows Support Group
Primary Specialty
Nursing Facility/Intermediate Care Facility
Enumeration Date
Feb 23, 2015
Last Updated
Feb 23, 2015

Practice Location

Address
4880 BROOKHILL TER
ZIP Code
92509-4047
Phone
(760) 743-3714

Authorized Official

Name
WADE WILDE
Title
EXECUTIVE DIRECTOR
Phone
(760) 743-3714

Specialties & Taxonomy Codes

Specialty
Nursing Facility/Intermediate Care Facility

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