Mountain Shadows Support Group, Inc.
NPI 1063561991ActiveOrganization· Nursing Facility/Intermediate Care Facility· Moreno Valley, CA
Nursing Facility/Intermediate Care Facility in Moreno Valley, California, registered in NPPES in January 2007. The authorized official on file is Lupe Bryson, Business Office Manager.
Overview
| NPI | 1063561991 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 9, 2007 |
| Last updated in NPPES | Sep 9, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nursing Facility/Intermediate Care Facility Primary | 313M00000X | LTC80143F | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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