MOUNTAIN SHADOWS SPECIAL KIDS HOMES-GARTH
NPI 1104280361
Intermediate Care Facility, Intellectual Disabilities in Jurupa Valley, CA
About Mountain Shadows Special Kids Homes-garth NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MOUNTAIN SHADOWS SPECIAL KIDS HOMES-GARTH (NPI 1104280361) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Jurupa Valley, California and active in the NPI registry since April 2016. The organization lists Lupe Bryson, Business Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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's NPI number?
The NPI number for Mountain Shadows Support Group is 1104280361. It was assigned to this organization in the NPPES registry on April 13, 2016. The provider is doing business as Mountain Shadows Special Kids Homes-Garth.
Where is Mountain Shadows Support Group located?
Mountain Shadows Support Group is located at 4287 Garth St, Jurupa Valley, CA 92509. The listed phone number is (760) 743-3714.
What is Mountain Shadows Support Group'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 was last updated on April 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Mountain Shadows Special Kids Homes-Garth · NPI 1104280361
Intermediate Care Facility, Intellectual Disabilities organization in Jurupa Valley, California. Organization record, active in the CMS NPPES registry since April 13, 2016.
## Identity
- **NPI:** 1104280361 (Entity type: Organization)
- **Enumerated:** April 13, 2016
- **Primary specialty:** Intermediate Care Facility, Intellectual Disabilities · taxonomy 315P00000X
- **Legal business name:** Mountain Shadows Support Group
- **Organization subpart:** No
- **Authorized official:** Lupe Bryson, BUSINESS OFFICE MANAGER
## Practice location
- **Address:** 4287 GARTH ST, Jurupa Valley, CA 92509-3316
- **Phone:** (760) 743-3714
## Record status
- **NPPES last updated:** April 19, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1104280361) · Data from the CMS NPPES public registry.