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Mountain Shadows Support Group, Inc
Nursing Facility/Intermediate Care Facility in Riverside, California
NPI 1306995220

Mountain Shadows Support Group, Inc is a Nursing Facility/Intermediate Care Facility based in Escondido, CA. Mountain Shadows Support Group, Inc practices in Riverside, CA. The NPI Number for Mountain Shadows Support Group, Inc is 1306995220 and holds a License No. LTC80004G (California).

The current practice location address for Mountain Shadows Support Group, Inc is 4704 Teasdale Ave, Riverside, CA and can be reached out via phone at 760-743-3714 and via fax at 760-743-9937.

Location: 4704 Teasdale Ave, Riverside, CA, 92026-1810
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1306995220
Provider Name
Mountain Shadows Support Group, Inc
Credential
Provider Entity Type
Organization
Address
4704 Teasdale Ave, Riverside, CA, 92026-1810
Phone Number
760-743-3714
Fax Number
760-743-9937
Provider Enumeration Date
01/09/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LTC80004H 05 CA
LTC8004G 05 CA
institution
Provider Business Practice Location Address Details
Address
4704 Teasdale Ave
City
Riverside
State
California
Zip
92509-4043
Phone Number
760-743-3714
Fax Number
760-743-9937
person
Provider Business Mailing Address Details
Address
4704 Teasdale Ave
City
Riverside
State
California
Zip
92509-4043
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.
LTC80004G (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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