SHADOW MOUNTAIN LLC. (NPI# 1295154888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295154888 |
Entity Type | Organization |
Organization Name | SHADOW MOUNTAIN LLC. |
Other Organization Name | SHADOW MOUNTAIN RECOVERY, TAOS |
Practice Address |
250 Shadow Mountain Rd. Taos NM 87571 |
Mailing Address |
Po Box 830525 Department # Sf 57 Birmingham AL 35283-0525 |
Practice Telephone | 5757514851 |
Mailing Telephone | 9314517757 |
Mailing Fax Number | 9319337762 |
Enumeration Date | 2014-04-10 |
Last Update Date | 2017-05-10 |
Authorized Official Name | JACKIE HOLUB (VICE PRESIDENT) |
Authorized Official Telephone | 9253898591 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 324500000X | Substance Abuse Rehabilitation Facility | STATE WAIVER | NM | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
Shadow Mountain Recovery, Taos | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164896197 | Shadow Mountain LLC. | Substance Abuse Rehabilitation Facility | 2102 University Park Blvd., Colorado Springs, CO 80918 | 2015-11-13 |
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 |
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 |
Street Address |
250 SHADOW MOUNTAIN RD. |
City | TAOS |
State | NM |
Zip Code | 87571 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376150912 | Colleen Struhar | Counselor | 250 Shadow Mountain Rd., Taos, NM 87571 | 2020-09-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174080923 | Veronika Anne Peacetree | Counselor | Vds-taos, 314 Don Fernando Street, Taos, NM 87571 | 2019-02-28 |
1043785603 | Lindsey M Schreiber | Counselor | 412 Sipapu Street, Taos, NM 87571 | 2018-10-10 |
1881173698 | Mia M Mcmullen | Specialist/Technologist | Enos Garcia Elementary School, 305 Don Fernando St, Taos, NM 87571 | 2018-08-13 |
1992225403 | Ted Dimond | Counselor | 525 Salazar Rd, Suite A, Taos, NM 87571 | 2017-06-26 |
1467908103 | Jacqueline Danielle Arcand | Social Worker | 250 Shadow Mountain Rd, Taos, NM 87571 | 2016-09-01 |
1225487812 | James Lucero | Social Worker | 905 Witt Rd., Taos, NM 87571 | 2016-06-06 |
1083098370 | Ellen Durant | Marriage & Family Therapist | 1135 Butterfly Rd, Taos, NM 87571 | 2015-07-16 |
1831584192 | Eight Northern Indian Pueblos Council, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1130 Butterfly Rd., Taos, NM 87571 | 2015-04-03 |
1790179844 | Eight Northern Indian Pueblos | Substance Abuse Rehabilitation Facility | 1130 Butterfly Road, Taos, NM 87571 | 2015-03-26 |
1992106041 | Debbie I Salazar, Lisw Ltd Co | Community/Behavioral Health | 208 Ranchitos Road Unit B, Taos, NM 87571 | 2014-09-09 |
Find all providers in zip 87571 |
Taxonomy Code | 324500000X |
Grouping | Residential Treatment Facilities |
Classification | 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. |
Notes: [7/1/2003: modified title, modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194924928 | Rio Grande Alcoholism Treatment Center Incorporated | Substance Abuse Rehabilitation Facility | 224 Cruz Alta Rd Ste J, Taos, NM 87571-5947 | 2007-07-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518505452 | Innovative Mat Solutions, LLC | Substance Abuse Rehabilitation Facility | 2215 Ambassador Rd Ne Apt 37, Albuquerque, NM 87112-2767 | 2019-12-11 |
1225509250 | Recovery House LLC | Substance Abuse Rehabilitation Facility | 9171 Glendale Ave Ne, Albuquerque, NM 87122-3805 | 2018-12-17 |
1427535251 | Full Circle Recovery | Substance Abuse Rehabilitation Facility | 3056 Frontier Ave. Ne, Albuquerque, NM 87106-8710 | 2018-07-24 |
1679007744 | Eight Northern Indian Pueblos | Substance Abuse Rehabilitation Facility | 579 White Swan Rd, 327 Eagle Drive, Ohkay Owingeh, NM 87566 | 2017-04-17 |
1619269446 | The Jericho House | Substance Abuse Rehabilitation Facility | 2845 Dona Ana Rd, Las Cruces, NM 88007-5239 | 2011-05-12 |
1063641819 | Nm Department of Health | Substance Abuse Rehabilitation Facility | 100 Calle De Central, Fort Bayard, NM 88036 | 2009-07-14 |
1376770214 | The Consortium | Substance Abuse Rehabilitation Facility | 571 North Tenth Street, Fort Sumner, NM 88119-0427 | 2009-06-18 |
1386870137 | Dismas House Nm Inc. | Substance Abuse Rehabilitation Facility | 701 Candelaria Rd Nw, Albuquerque, NM 87107-2407 | 2009-06-08 |
1760621007 | Shadow Mountain LLC. | Substance Abuse Rehabilitation Facility | 5400 Gibson Blvd. S. E, 3rd Floor, Albuquerque, NM 87109 | 2009-02-10 |
1235375460 | Regional Substance Abuse Treatment Initiative | Substance Abuse Rehabilitation Facility | 519 North 10th. Street, Fort Sumner, NM 88119 | 2008-12-17 |
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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.