MOUNTAIN SHADOWS COMMUNITY HOMES-OLIVE
NPI 1396894291
Nursing Facility/Intermediate Care Facility in Escondido, CA

Q: What is Mountain Shadows Support Group's NPI number?

The NPI number for Mountain Shadows Support Group is 1396894291. It was assigned to this organization in the NPPES registry on January 9, 2007. The provider is doing business as Mountain Shadows Community Homes-Olive.

Q: What is Mountain Shadows Support Group's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Active since January 09, 2007

2067 W EL NORTE PKWY, ESCONDIDO, CA 92026(760) 743-3714(760) 743-9937 Get Directions Write a Review

NPPES record last updated: November 9, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mountain Shadows Community Homes-olive NPPES

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

MOUNTAIN SHADOWS COMMUNITY HOMES-OLIVE (NPI 1396894291) is a healthcare organization registered as a nursing facility/intermediate care facility in Escondido, California and active in the NPI registry since January 2007. The organization lists Lupe Bryson, Business Office Manager, as its authorized official.

NPPES Registry Identity

NPI1396894291

Entity TypeOrganization

Primary Taxonomy313M00000X

Legal Business NameMOUNTAIN SHADOWS SUPPORT GROUP

Location Address2067 W EL NORTE PKWYEscondido, CA 92026-1810

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 DateJanuary 9, 2007

Last NPPES UpdateNovember 9, 2011

✔ NPI 1396894291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities

Taxonomy Code313M00000X

License✔ Licensed in CA · 090000253

Definition

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

Also ListedIntermediate Care Facility, Intellectual DisabilitiesTaxonomy 315P00000X · License LTC60136I (CA)

2067 W EL NORTE PKWY, Escondido, CA 92026

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Other Names 1

Doing Business AsMountain Shadows Community Homes-olive

Other Identifiers 1

MedicaidLTC60136ICA

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOUNTAIN SHADOWS SUPPORT GROUP, INC