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Mountain Shadows Support Group, Inc.
Nursing Facility/Intermediate Care Facility in Moreno Valley, California
NPI 1215061767

Mountain Shadows Support Group, Inc. is a Nursing Facility/Intermediate Care Facility based in Escondido, CA. Mountain Shadows Support Group, Inc. practices in Moreno Valley, CA. The NPI Number for Mountain Shadows Support Group, Inc. is 1215061767 and holds a License No. 46989489 (California).

The current practice location address for Mountain Shadows Support Group, Inc. is 25654 Sierra Leone Ct, Moreno Valley, CA and can be reached out via phone at 760-743-3714 and via fax at 760-743-9937.

Location: 25654 Sierra Leone Ct, Moreno Valley, CA, 92026-1810
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1215061767
Provider Name
Mountain Shadows Support Group, Inc.
Credential
Provider Entity Type
Organization
Address
25654 Sierra Leone Ct, Moreno Valley, CA, 92026-1810
Phone Number
760-743-3714
Fax Number
760-743-9937
Provider Enumeration Date
03/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LTC80195G 05 CA
LTC80195F 05 CA
institution
Provider Business Practice Location Address Details
Address
25654 Sierra Leone Ct
City
Moreno Valley
State
California
Zip
92551-2100
Phone Number
760-743-3714
Fax Number
760-743-9937
person
Provider Business Mailing Address Details
Address
25654 Sierra Leone Ct
City
Moreno Valley
State
California
Zip
92551-2100
Phone Number
760-743-3714
Fax Number
760-743-9937
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Nursing Facility/Intermediate Care Facility
Speciality
-
Taxonomy
313M00000X
License No.
46989489 (California)
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
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