SHADOW MOUNTAIN LLC.


Address: 2102 University Park Blvd., Colorado Springs, CO 80918
Phone: 7192668876

SHADOW MOUNTAIN LLC. (NPI# 1164896197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164896197
Entity Type Organization
Organization Name SHADOW MOUNTAIN LLC.
Other Organization Name SHADOW MOUNTAIN RECOVERY, UNIVERSITY PARK
Practice Address 2102 University Park Blvd.
Colorado Springs
CO 80918
Mailing Address Po Box 830525
Dpeartment # Sf 59
Birmingham
AL 35283-0525
Practice Telephone 7192668876
Mailing Telephone 9314517757
Mailing Fax Number 9319337762
Enumeration Date 2015-11-13
Last Update Date 2017-04-27
Authorized Official Name JACKIE HOLUB (VICE PRESIDENT)
Authorized Official Telephone 9253898591
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 324500000X Substance Abuse Rehabilitation Facility Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Shadow Mountain Recovery, University Park Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1699182410 Shadow Mountain LLC. Clinic/Center 8200 E. Belleview Blvd., Suite 400e, Greenwood Village, CO 80111 2014-07-14
1831505874 Shadow Mountain LLC. Special Hospital 120 W. 1470 South, Building B, St. George, UT 84770 2014-07-10
1154733558 Shadow Mountain LLC. Substance Abuse Rehabilitation Facility 5250 Pikes Peak Highway, Cascade, CO 80809 2014-05-20
1295154888 Shadow Mountain LLC. Substance Abuse Rehabilitation Facility 250 Shadow Mountain Rd., Taos, NM 87571 2014-04-10
1760621007 Shadow Mountain LLC. Substance Abuse Rehabilitation Facility 5400 Gibson Blvd. S. E, 3rd Floor, Albuquerque, NM 87109 2009-02-10
1437521507 Shadow Mountain LLC. Substance Abuse Rehabilitation Facility 5400 Gibson Blvd Se, Third Floor, Suite A, Albuquerque, NM 87108-4729 2015-10-28
1801226709 Shadow Mountain LLC. Community/Behavioral Health 1155 Kelly Johnson Blvd, Suite 201, Colorado Springs, CO 80920-3932 2013-11-14

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Shadow Mountain LLC 5893 Shasta Circle, Littleton, CO 80123

Office Location

Street Address 2102 UNIVERSITY PARK BLVD.
City COLORADO SPRINGS
State CO
Zip Code 80918

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952917056 Uch-mhs Clinic/Center 5818 North Nevada, Suite 200, Colorado Springs, CO 80918 2020-09-23
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1821619321 Kayla Sanchez Behavior Technician Keystone Achievements, 5526 N. Academy Blvd, Colorado Springs, CO 80918 2020-05-06
1548801418 Kelly Cottos Chiropractor 7075 Lexington Drive, Colorado Springs, CA 80918 2019-10-02
1568016038 Overcomers Counseling Counselor 5585 Erindale Dr., Colorado Springs, CO 80918 2019-08-01
1457915522 Joanne Beth Kuhn Counselor 6095 Kingdom View, Colorado Springs, CO 80918 2019-04-24
1780140210 Megan Kennedy Chiropractor 6210 Lehman Drive Suite 100, Colorado Springs, CO 80918 2019-02-20
1871069864 Jennifer Potage Counselor 6035 Erin Park Dr. Suite 102, Colorado Springs, CO 80918 2018-10-17
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Taxonomy Information

Taxonomy Code 324500000X
Grouping Residential Treatment Facilities
Classification Substance Abuse Rehabilitation Facility

Taxonomy Definition

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.
Notes: [7/1/2003: modified title, modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1174069223 Courage To Change Substance Abuse Rehabilitation Facility 3470 Briargate Blvd, Colorado Springs, CO 80920-4168 2017-01-12
1487028577 Crossroads' Turning Points, Inc. Substance Abuse Rehabilitation Facility 411 S Cascade Ave, Colorado Springs, CO 80903-3809 2015-11-30
1922434182 El Paso County Community Detox Facility Substance Abuse Rehabilitation Facility 2723 E. Las Vegas St., Colorado Springs, CO 80906 2013-09-19
1801418660 Crossroads' Turning Points, Inc. Substance Abuse Rehabilitation Facility 1026 Maxwell St, Colorado Springs, CO 80906-5554 2020-05-14
1275076283 Serenity Peaks Recovery Center Substance Abuse Rehabilitation Facility 2270 La Montana Way, Suite 100, Colorado Springs, CO 80918-6715 2016-11-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1295336071 Sobriety House, Inc. Substance Abuse Rehabilitation Facility 1368 Elizabeth St, Denver, CO 80206-2309 2020-11-06
1548874308 Lotus Lodge, LLC Substance Abuse Rehabilitation Facility 206 Uvalda St, Aurora, CO 80011-8602 2020-08-31
1710591573 Lotus Lodge Men, LLC Substance Abuse Rehabilitation Facility 16313 E 7th Dr, Aurora, CO 80011-4524 2020-08-31
1710509583 Crossroads' Turning Points, Inc. Substance Abuse Rehabilitation Facility 1004 Carbon Place, Trinidad, CO 81082 2020-05-14
1538796156 Rocky Mountain Detox, LLC Substance Abuse Rehabilitation Facility 1336 Pierce St, Lakewood, CO 80214-1939 2020-03-24
1215574413 Healing Pines Recovery, LLC. Substance Abuse Rehabilitation Facility 5550 County Road 124, Elizabeth, CO 80107 2019-12-06
1790328607 Gallus Detox Denver LLC Substance Abuse Rehabilitation Facility 5920 S Estes St Ste 150, Littleton, CO 80123-8620 2019-10-23
1114584232 Scw Recovery LLC Substance Abuse Rehabilitation Facility 330 Fiedler Ave, Ste 103, Dillon, CO 80435 2019-05-23
1902462617 Colorado West Regional Mental Health, Inc. Substance Abuse Rehabilitation Facility 2800 Riverside Pkwy Bldg 2, Grand Junction, CO 81501-4721 2019-05-17
1487122057 Valiant Dtx, LLC Substance Abuse Rehabilitation Facility 2602 S Ensenada Way, Aurora, CO 80013-7690 2018-11-12
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Competitor

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City COLORADO SPRINGS
Zip Code 80918

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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