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 1700901931 since 2007. The authorized official on file is Lupe Bryson, Business Office Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1700901931 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Mountain Shadows Support Group, Inc |
| Other name | <Unavail> |
| Practice address | 11315 LINDLEY LN, Moreno Valley, CA, 92555 |
| Phone | 7607433714 |
| Fax | 7607439937 |
| Enumeration date | 2007-03-20 |
| 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 |
|---|---|---|---|
| LTC80338F | Medicaid | CA | — |
| LTC80338G | Medicaid | CA | — |
Copy-ready billing details
Provider: Mountain Shadows Support Group, Inc NPI: 1700901931 Taxonomy: 313M00000X (Nursing Facility/Intermediate Care Facility) Address: 11315 LINDLEY LN, Moreno Valley, CA, 92555
Verify this record
Cross-check NPI 1700901931 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 type of organization is Mountain Shadows Support Group, Inc?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-12-26.