Mountain Shadows Support Group
Mountain Shadows Support Group is an Intellectual Disabilities Intermediate Care Facility in San Marcos, California. Licensed in California. Registered with an NPI since 2014.
- Licensed in
- CA
- In the registry since
- 2014
Practice location Address checks out
689 Dane DrSan Marcos, CA 92069-5825
Phone: (760) 743-3714
Fax: (760) 736-4173
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Specialties & licences
| Intellectual Disabilities Intermediate Care Facility (primary) | Taxonomy 315P00000X · Licence 550003036 (CA) |
|---|
Record details
| NPI number | 1992107221 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Wade Wilde — Executive Director · (760) 743-3714 |
| Other names | Mtn. Shadows Community Homes- Fig House |
| NPI enumerated | September 18, 2014 |
| Last updated in NPPES | March 23, 2016 |
| Mailing address | 970 Los Vallecitos Blvd Ste 240, San Marcos, CA 92069-1475 |
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