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Mountain Shadows Support Group, Inc.
Intellectual Disabilities Intermediate Care Facility in San Marcos, California
NPI 1235254582

Mountain Shadows Support Group, Inc. is a Intellectual Disabilities Intermediate Care Facility based in Escondido, CA. Mountain Shadows Support Group, Inc. practices in San Marcos, CA. The NPI Number for Mountain Shadows Support Group, Inc. is 1235254582 and holds a License No. 46989489 (California).

The current practice location address for Mountain Shadows Support Group, Inc. is 866 Viking Ln, San Marcos, CA and can be reached out via phone at 760-743-3714 and via fax at 760-743-9937.

Location: 866 Viking Ln, San Marcos, CA, 92026-1810
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1235254582
Provider Name
Mountain Shadows Support Group, Inc.
Credential
Provider Entity Type
Organization
Address
866 Viking Ln, San Marcos, CA, 92026-1810
Phone Number
760-743-3714
Fax Number
760-743-9937
Provider Enumeration Date
03/19/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LTC60744G 05 CA
institution
Provider Business Practice Location Address Details
Address
866 Viking Ln
City
San Marcos
State
California
Zip
92069-5806
Phone Number
760-743-3714
Fax Number
760-743-9937
person
Provider Business Mailing Address Details
Address
866 Viking Ln
City
San Marcos
State
California
Zip
92069-5806
Phone Number
760-743-3714
Fax Number
760-743-9937
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
46989489 (California)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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