1. Home
  2. Directory
  3. California
  4. San Marcos
  5. Intermediate Care Facility Mentally Retarded
  6. NPI Profile

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

Active since March 20, 2007
600 ROSE CT, SAN MARCOS, CA 92069(760) 743-3714(760) 743-9937 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mountain Shadows Community Homes - Elm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOUNTAIN SHADOWS COMMUNITY HOMES - ELM (NPI 1003931262) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in San Marcos, California and active in the NPI registry since March 2007. The organization lists Lupe Bryson, Business Office Manager, as its authorized official.

NPPES Registry Identity

NPI1003931262
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameMOUNTAIN SHADOWS SUPPORT GROUP, INC.
Location Address600 ROSE CTSan Marcos, CA 92069-5828
Mailing Address2067 W El Norte PkwyEscondido, CA 92026-1810 · (760) 743-3714 · Fax (760) 743-9937
Phone(760) 743-3714
Fax(760) 743-9937
Organization SubpartNo
Authorized OfficialLupe BrysonBusiness Office Manager · (760) 743-3714
Enumeration DateMarch 20, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1003931262 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License✔ Licensed in CA · 46989489
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
600 ROSE CT, San Marcos, CA 92069
Open in Google Maps ↗

Other Names 1

Doing Business AsMountain Shadows Community Homes - Elm

Other Identifiers 1

MedicaidLTC60741GCA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2267003

Mountain Shadows Support Group · Escondido, CA
Expired · Aug 17, 2026
CLIA Number05D2267003
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateAugust 18, 2024
Certificate Expiration DateAugust 17, 2026
Laboratory DirectorMichael N. Markopoulos
Laboratory Phone(760) 743-3714
Laboratory LocationMountain Shadows Support Group2067 W El Norte Parkway, Escondido, CA 92026
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mountain Shadows Support Group, Inc.'s NPI number?

The NPI number for Mountain Shadows Support Group, Inc. is 1003931262. It was assigned to this organization in the NPPES registry on March 20, 2007. The provider is doing business as Mountain Shadows Community Homes - Elm.

Where is Mountain Shadows Support Group, Inc. located?

Mountain Shadows Support Group, Inc. is located at 600 Rose Ct, San Marcos, CA 92069. The listed phone number is (760) 743-3714.

What is Mountain Shadows Support Group, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Mountain Shadows Support Group, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.