MOUNTAIN SHADOWS COMMUNITY HOMES - ELM
NPI 1003931262
Intermediate Care Facility, Intellectual Disabilities in San Marcos, CA

NPI Status: Active since March 20, 2007

Contact Information

600 ROSE CT
SAN MARCOS, CA
ZIP 92069
Phone: (760) 743-3714
Fax: (760) 743-9937

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  • Organization
  • Intermediate Care Facility, Intellectual...
  • CLIA Number: 05D2267003
  • CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
  • CLIA Exp. Date: 08-17-2026

About MOUNTAIN SHADOWS COMMUNITY HOMES - ELM

This page provides the complete NPI Profile along with additional information for Mountain Shadows Community Homes - Elm, a provider established in San Marcos, California operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1003931262 assigned on March 2007. The practitioner's primary taxonomy code is 315P00000X with license number 46989489 (CA). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Mountain Shadows Community Homes - Elm. The authorized official of this NPI record is Lupe Bryson (Business Office Manager)

NPI
1003931262
Provider Legal Name
MOUNTAIN SHADOWS SUPPORT GROUP, INC.
Other Organization Name
MOUNTAIN SHADOWS COMMUNITY HOMES - ELM
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
600 ROSE CT SAN MARCOS, CA 92069
Location Phone
(760) 743-3714
Location Fax
(760) 743-9937
Mailing Address
2067 W EL NORTE PKWY ESCONDIDO, CA 92026
Mailing Phone
(760) 743-3714
Mailing Fax
(760) 743-9937
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-20-2007
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Intermediate Care Facility, Intellectual Disabilities

Taxonomy Code
315P00000X
Type
Nursing & Custodial Care Facilities
License No.
46989489
License State
CA
Taxonomy Description
An intermediate care facility providing services for individuals with intellectual disabilities.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

LUPE BRYSON

Authorized Official Title
BUSINESS OFFICE MANAGER
Authorized Official Phone
(760) 743-3714

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
LTC60741GMEDICAID (05)CA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2267003
Facility Type
Intermediate Care Facility for Mentally Retarded
Certificate Effective Date
August 18, 2024
Certificate Expiration Date
August 17, 2026
Laboratory Director
MICHAEL N. MARKOPOULOS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Mountain Shadows Community Homes - Elm to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1003931262, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
0
Doubled → 0
Pos 4
3
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
3
Unchanged
Pos 7
1
Doubled → 2
Pos 8
2
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 9 → 18 → 9 1 → 2 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 0 + 3 + 1 + 8 + 3 + 2 + 2 + 1 + 2 + 24 = 48

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 48 is 50. The difference is the calculated check digit.

50 - 48 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1003931262.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003931262, enumerated as an "organization" on March 20, 2007.

The provider is located at 600 ROSE CT SAN MARCOS, CA 92069 and the phone number is (760) 743-3714.

Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.