Organization
MOUNTAIN SHADOWS SUPPORT GROUP
Active
Other names
MOUNTAIN SHADOWS SPECIAL KIDS HOMES-JOSHUA
Organization subpart
No
Provider details
NPI number
Authorized official
LUPE BRYSON (BUSINESS OFFICE MANAGER)
(760) 743-3714
Entity
Organization
Contact information
Practice address
7719 JOSHUA RD., JURUPA VALLEY, CA 92509-3317
(760) 743-3714
Mailing address
970 LOS VALLECITOS BLVD, SUITE 240, SAN MARCOS, CA 92069-1473
(760) 743-3714
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
CA
Other
Enumeration date
04/13/2016
Last updated
05/06/2016
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