Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mountain Shadows Support Group, Inc

Organization Nursing Facility/Intermediate Care Facility · NPI 1306995220

Mountain Shadows Support Group, Inc is a Nursing Facility/Intermediate Care Facility in Riverside, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4704 Teasdale Ave
Riverside, CA 92509-4043
Phone: (760) 743-3714
Fax: (760) 743-9937
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nursing Facility/Intermediate Care Facility (primary) Taxonomy 313M00000X · Licence LTC80004G (CA)

Record details

NPI number1306995220
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lupe Bryson — Business Office Manager · (760) 743-3714
Other names Special Kids Homes-Bain House
NPI enumeratedJanuary 9, 2007
Last updated in NPPESDecember 26, 2007
Mailing address2067 W El Norte Pkwy, Escondido, CA 92026-1810

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