Mountain Shadows Support Group, Inc.
Mountain Shadows Support Group, Inc. is a healthcare organization registered as Nursing Facility/Intermediate Care Facility in Moreno Valley, CA, holding Type 2 (organization) NPI 1215061767 since 2007. The authorized official on file is Lupe Bryson, Business Office Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1215061767 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Mountain Shadows Support Group, Inc. |
| Other name | <Unavail> |
| Practice address | 25654 SIERRA LEONE CT, Moreno Valley, CA, 92551 |
| Phone | 7607433714 |
| Fax | 7607439937 |
| Enumeration date | 2007-03-15 |
| Last updated in NPPES | 2007-12-26 |
Authorized official
| Name | Lupe Bryson |
|---|---|
| Title | Business Office Manager |
| Phone | 7607433714 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 313M00000X | Nursing Facility/Intermediate Care Facility | Primary | 46989489 | CA |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC80195G | Medicaid | CA | — |
| LTC80195F | Medicaid | CA | — |
Copy-ready billing details
Provider: Mountain Shadows Support Group, Inc. NPI: 1215061767 Taxonomy: 313M00000X (Nursing Facility/Intermediate Care Facility) Address: 25654 SIERRA LEONE CT, Moreno Valley, CA, 92551
Verify this record
Cross-check NPI 1215061767 against the authoritative CMS record: view Mountain Shadows Support Group, Inc. on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Where is Mountain Shadows Support Group, Inc. located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-12-26.