SHADOW MOUNTAIN LLC. NPI 1831505874

NPI Information

SHADOW MOUNTAIN LLC. is a special hospital in St. George, UT. The provider is a designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical. SHADOW MOUNTAIN LLC. NPI is 1831505874. The provider is registered as an organization entity type.
The provider Is Doing Business As Shadow Mountain Detox Hospital, St. George.

The provider's business location address is:

120 W. 1470 SOUTH
BUILDING B
ST. GEORGE, UT
ZIP 84770
Phone: (435) 272-0220
Fax: (435) 272-0222

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 7/10/2014 and was last updated on 4/26/2017.

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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