| NPI | 1396894291 |
|---|---|
| Doing Business As | MOUNTAIN SHADOWS COMMUNITY HOMES-OLIVE |
| Entity Type | Organization |
| Authorized Contact | LUPE BRYSON Business Office Manager 760-743-3714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: CA 090000253) |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: CA LTC60136I) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2011-11-09 |