SHADOW MOUNTAIN LLC. NPI 1801226709

NPI Information

SHADOW MOUNTAIN LLC. is a substance abuse rehabilitation facility in Colorado Springs, CO. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. SHADOW MOUNTAIN LLC. NPI is 1801226709. The provider is registered as an organization entity type.
The provider Is Doing Business As Shadow Mountain Recovery, Colorado Springs.

The provider's business location address is:

1155 KELLY JOHNSON BLVD
SUITE 201
COLORADO SPRINGS, CO
ZIP 80920-932
Phone: (719) 418-3737

The provider's authorized official is Jackie Holub .
The authorized official title is Vice President and has the following contact phone number (925) 389-8591.

The enumeration date for this NPI number is 11/14/2013 and was last updated on 2/27/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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