Mountain Shadows Support Group, Inc
Mountain Shadows Support Group, Inc is a healthcare organization registered as Nursing Facility/Intermediate Care Facility in Riverside, CA, holding Type 2 (organization) NPI 1306995220 since 2007. The authorized official on file is Lupe Bryson, Business Office Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1306995220 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Mountain Shadows Support Group, Inc |
| Other name | <Unavail> |
| Practice address | 4704 TEASDALE AVE, Riverside, CA, 92509 |
| Phone | 7607433714 |
| Fax | 7607439937 |
| Enumeration date | 2007-01-09 |
| 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 | LTC80004G | CA |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC80004H | Medicaid | CA | — |
| LTC8004G | Medicaid | CA | — |
Copy-ready billing details
Provider: Mountain Shadows Support Group, Inc NPI: 1306995220 Taxonomy: 313M00000X (Nursing Facility/Intermediate Care Facility) Address: 4704 TEASDALE AVE, Riverside, CA, 92509
Verify this record
Cross-check NPI 1306995220 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
What is a Type 2 NPI?
What type of organization is Mountain Shadows Support Group, Inc?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2007-12-26.