Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Mountain Shadows Support Group, Inc.

Nursing Facility/Intermediate Care Facility in Moreno Valley, CA · enumerated 2007 · authorized official Lupe Bryson, Business Office Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1215061767

Verified

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Registry record

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 (760) 743-3714

Fax (760) 743-9937

Enumeration date Mar 15, 2007

Last updated in NPPES Dec 26, 2007

Taxonomy & classification

313M00000X Nursing Facility/Intermediate Care Facility Nursing & Custodial Care Facilities · License 46989489 (CA) Primary

Authorized official

Name Lupe Bryson

Title Business Office Manager

Phone (760) 743-3714

Other identifiers

Identifier	Type	State	Issuer
LTC80195G	Medicaid	CA	-
LTC80195F	Medicaid	CA	-

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.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2007-12-26. Verify at npiregistry.cms.hhs.gov.

Where is Mountain Shadows Support Group, Inc. located?

The practice location on file with NPPES is in Moreno Valley, CA.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2007-12-26.