MOUNTAIN SHADOWS SUPPORT GROUP, INC. (NPI# 1871618033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871618033 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN SHADOWS SUPPORT GROUP, INC. |
| Other Organization Name | MTN.SHADOWS COMMUNITY HOMES-MAPLE |
| Practice Address |
2067 W El Norte Pkwy Escondido CA 92026-1810 |
| Practice Telephone | 7607433714 |
| Practice Fax Number | 7607439937 |
| Mailing Telephone | 7607433714 |
| Mailing Fax Number | 7607439937 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LUPE BRYSON (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 7607433714 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 46989489 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LTC60210H | 05 |
| Other Name | Type Code |
|---|---|
| Mtn.Shadows Community Homes-Maple | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003931262 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 600 Rose Ct, San Marcos, CA 92069-5828 | 2007-03-20 |
| 1750406070 | Mountain Shadows Support Group, Inc. | Nursing Facility/Intermediate Care Facility | 4680 Glen St, Riverside, CA 92509-3005 | 2007-03-20 |
| 1407971633 | Mountain Shadows Support Group, Inc. | Nursing Facility/Intermediate Care Facility | 7456 River Glen Dr, Riverside, CA 92509-3451 | 2007-03-20 |
| 1235254582 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 866 Viking Ln, San Marcos, CA 92069-5806 | 2007-03-19 |
| 1215061767 | Mountain Shadows Support Group, Inc. | Nursing Facility/Intermediate Care Facility | 25654 Sierra Leone Ct, Moreno Valley, CA 92551-2100 | 2007-03-15 |
| 1063561991 | Mountain Shadows Support Group, Inc. | Nursing Facility/Intermediate Care Facility | 27344 Darlene Dr, Moreno Valley, CA 92555-2126 | 2007-01-09 |
| 1396860540 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1972628121 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1922123181 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1710002951 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| Street Address |
2067 W EL NORTE PKWY |
| City | ESCONDIDO |
| State | CA |
| Zip Code | 92026-1810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396894291 | Mountain Shadows Support Group | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-01-09 |
| 1396860540 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1972628121 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1922123181 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1710002951 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1720103971 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1831214071 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1982729133 | Mountain Shadows Support Group, Inc | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1912022161 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1265557417 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477908663 | Nancy Martinez-molano | Counselor | 1029 N. Broadway Avenue, Escondido, CA 92026 | 2016-04-26 |
| 1114322765 | Christina Boekamp | Speech-Language Pathologist | 1325 Las Villas Way, Escondido, CA 92026 | 2014-10-24 |
| 1609170356 | Pectus Services of Southern California LLC | Durable Medical Equipment & Medical Supplies | 317 N. Elcamino Real, Suite 502, Encinitas, CA 92026 | 2011-01-10 |
| 1518277987 | Maryam Delsen | Social Worker | 1029 N. Broadway Ave., Escondido, CA 92026 | 2010-10-19 |
| 1528372554 | Shirley Dianne Kunkel | Speech-Language Pathologist | 9649 Galatea Lane, Escondido, CA 92026 | 2010-08-02 |
| 1124295266 | Kendell Hales Ricks | Dentist | 8895 Lawrence Welk Dr, Escondido, CA 92026 | 2008-05-08 |
| 1861517005 | Mountain Shadows Support Group, Inc | Nursing Facility/Intermediate Care Facility | 4840 Fairhill Place, Riverside, CA 92026 | 2007-03-20 |
| 1982731253 | Cynthia Louise Canney | Marriage & Family Therapist | 502 W. El Norte Parkway, Excondido, CA 92026 | 2007-02-27 |
| 1992891790 | Vijaya Kv Prabhu | Dentist | El Norte Family Dental., 306 W.el Norte Pkwy. Suite D & E, Escondido, CA 92026 | 2006-10-05 |
| 1174065403 | Rashida Black | Counselor | 1341 N Escondido Blvd, Escondido, CA 92026 | 2016-11-17 |
| Find all providers in zip 92026 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (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. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396894291 | Mountain Shadows Support Group | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-01-09 |
| 1396860540 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1972628121 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1922123181 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1710002951 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1720103971 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1831214071 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1982729133 | Mountain Shadows Support Group, Inc | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1912022161 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| 1265557417 | Mountain Shadows Support Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2067 W El Norte Pkwy, Escondido, CA 92026-1810 | 2007-03-20 |
| Find all providers in ESCONDIDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.