<Unavail>

LBN: Mountain Shadows Support Group, Inc
<Unavail> is an health care organization with primary practice located at 4870 Fairhill Pl , Riverside CA 92509-4034. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. Mountain Shadows Support Group, Inc can be contacted via phone (760) 743-3714, or through Bryson, Lupe via phone (760) 743-3714.

Contact Information

Primary practice address
4870 Fairhill Pl Riverside CA 92509-4034
Phone: (760) 743-3714
Fax: (760) 743-9937
Website:
Map and Directions
Authorized official contact:
Name: Bryson, Lupe
Phone: (760) 743-3714

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 46989489 California

Profile Details

NPI number 1588789721
LBN Legal business name Mountain Shadows Support Group, Inc
DBA Doing business as <Unavail>
Authorized official Bryson, Lupe
Entity Organization
Organization subpart 1 No
Enumeration date Mar 20th, 2007
Last updated Dec 26th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588789721 NPPES
California MEDICAID LTC80251G
California MEDICAID LTC80251F

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