SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE – NPI #1760621007
Substance Abuse Rehabilitation Facility

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.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE is a substance abuse rehabilitation facility located in ALBUQUERQUE, NM. NPPES has assigned the NPI number 1760621007 to SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE on February 10, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE” is a dba name, the actual legal business name for this organization is SHADOW MOUNTAIN LLC.. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

The NPI profile was previously updated about 11 years ago on Oct 28, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE below.

NPI Profile for
SHADOW MOUNTAIN LLC.

NPI Number
1760621007
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SHADOW MOUNTAIN LLC.
Doing Business As (dba): SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE
Primary location
5400 GIBSON BLVD. S. E
3RD FLOOR
ALBUQUERQUE, NM 87109
Phone: (505) 296-8184 Fax:
Mailing address
5400 GIBSON BLVD. S.E
3RD FLOOR
ALBUQUERQUE, NM 87109
Phone: (505) 867-0214 Fax:
Organization Subpart
No
Authorized Official
JACKIE HOLUB
MANAGING DIRECTOR
Phone: (925) 389-8591
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.