Organization · Type 2 NPI
Mountain Shadows Support Group
Intellectual Disabilities Intermediate Care Facility · Jurupa Valley, CA
NPI number
1104280361
Active
Practice location
4287 Garth St
Jurupa Valley, CA 92509-3316
Mailing address
970 Los Vallecitos Blvd
San Marcos, CA 92069-1473
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | None listed |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1104280361
Mountain Shadows Support Group's National Provider Identifier is 1104280361, issued on Apr 13, 2016. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Jurupa Valley, CA. The record was last updated on Apr 19, 2016.