MOUNTAIN SHADOWS SUPPORT GROUP is an intermediate care facility mentally retarded in Escondido, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. MOUNTAIN SHADOWS SUPPORT GROUP NPI is 1346365590. The provider is registered as an organization entity type.
The provider Is Doing Business As Mtn. Shadows Community Homes - Jacaranda.
The provider's business location address is:
2067 W EL NORTE PKWY
ESCONDIDO, CA
ZIP 92026-810
Phone: (760) 743-3714
Fax: (760) 743-9937
The provider's authorized official is Guadalupe Bryson .
The authorized official title is Business Office Manager and has the following contact phone number (760) 743-3714.
The CLIA number assigned to this NPI record is 05D2267003 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/20/2007 and was last updated on 7/24/2019.