SPECIAL KIDS HOMES-GLEN HOUSE
NPI 1750406070
Nursing Facility/Intermediate Care Facility in Riverside, CA

NPI Status: Active since March 20, 2007

Contact Information

4680 GLEN ST
RIVERSIDE, CA
ZIP 92509
Phone: (760) 743-3714
Fax: (760) 743-9937

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About SPECIAL KIDS HOMES-GLEN HOUSE

This page provides the complete NPI Profile along with additional information for Special Kids Homes-glen House, a provider established in Riverside, California operating as a Nursing Facility/intermediate Care Facility. The healthcare provider is registered in the NPI registry with number 1750406070 assigned on March 2007. The practitioner's primary taxonomy code is 313M00000X with license number 46989489 (CA). The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as Special Kids Homes-glen House. The authorized official of this NPI record is Lupe Bryson (Business Office Manager)

NPI
1750406070
Provider Legal Name
MOUNTAIN SHADOWS SUPPORT GROUP, INC.
Other Organization Name
SPECIAL KIDS HOMES-GLEN HOUSE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
4680 GLEN ST RIVERSIDE, CA 92509
Location Phone
(760) 743-3714
Location Fax
(760) 743-9937
Mailing Address
2067 W EL NORTE PKWY ESCONDIDO, CA 92026
Mailing Phone
(760) 743-3714
Mailing Fax
(760) 743-9937
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
03-20-2007
Last Update Date
02-15-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nursing Facility/Intermediate Care Facility

Taxonomy Code
313M00000X
Type
Nursing & Custodial Care Facilities
License No.
46989489
License State
CA
Taxonomy Description
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

LUPE BRYSON

Authorized Official Title
BUSINESS OFFICE MANAGER
Authorized Official Phone
(760) 743-3714

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
LTC80008HMEDICAID (05)CA 
LTC80008GMEDICAID (05)CA 

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1750406070
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271008012014
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 8 + 0 + 1 + 2 + 0 + 1 + 4 + 24 = 50
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1750406070 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750406070, enumerated in the NPI registry as an "organization" on March 20, 2007

The provider is located at 4680 Glen St Riverside, Ca 92509 and the phone number is (760) 743-3714

This medical organization specializes in Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on March 20, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.