SHADOW MOUNTAIN RECOVERY (NPI# 1346787181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346787181 |
| Entity Type | Organization |
| Organization Name | SHADOW MOUNTAIN RECOVERY |
| Practice Address |
1155 Kelly Johnson Blvd Colorado Springs CO 80920-3932 |
| Practice Telephone | 6152996661 |
| Mailing Telephone | 6152996661 |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2017-01-31 |
| Authorized Official Name | MRS. MARY ELIZABETH LEVATINO (DIRECTOR OF AR) |
| Authorized Official Telephone | 6152996661 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
CO | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Shadow Mountain Recovery LLC | 5314 Maryland Way, Suite 300, Brentwood, TN 37027 |
| Street Address |
1155 KELLY JOHNSON BLVD |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80920-3932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366427825 | Bruce John Zimmerman | Dentist | 1155 Kelly Johnson Blvd, Suite 210, Colorado Springs, CO 80920-3932 | 2005-12-07 |
| 1922565480 | Alicia Vashti Jacobson | Behavior Technician | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2019-02-20 |
| 1538659784 | Janessa Ybarra | Behavior Technician | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2018-05-14 |
| 1215443619 | Lynn M Gilbert | Behavior Technician | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2017-12-20 |
| 1790219947 | Shirlane Diane Winburn | Behavioral Analyst | 1155 Kelly Johnson Blvd, Ste 150, Colorado Springs, CO 80920-3932 | 2017-04-14 |
| 1881131852 | Mustard Seed Healthcare Consulting, LLC | Ambulance | 1155 Kelly Johnson Blvd, Suite 111, Colorado Springs, CO 80920-3932 | 2017-01-27 |
| 1245682053 | Joy Warrington | Behavioral Analyst | 1155 Kelly Johnson Blvd, 150, Colorado Springs, CO 80920-3932 | 2016-07-05 |
| 1275997256 | Caitlyn Canfield | Behavioral Analyst | 1155 Kelly Johnson Blvd, 150, Colorado Springs, CO 80920-3932 | 2016-04-06 |
| 1184081663 | Paula Adams Adams | Behavioral Analyst | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2016-01-28 |
| 1851769152 | Teague Gearhart | Podiatrist | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2015-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463409 | Cynthia Cruz | Marriage & Family Therapist | 7710 N. Union, Ste 100b and 100c, Colorado Springs, CO 80920 | 2020-09-24 |
| 1851905178 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - Md, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-09-03 |
| 1114531431 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - Md, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1205440583 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - App, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1700490455 | Poudre Valley Medical Group, LLC | Radiology | 4080 Briargate Parkway, Colorado Springs, CO 80920 | 2020-09-01 |
| 1962015792 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - App, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-08-31 |
| 1194296491 | Kramer Dentistry Inc | Clinic/Center | 9290 Highland Ridge Heights Suite # 120, Colorado Springs, CO 80920 | 2018-12-12 |
| 1134602279 | Juliana Plucinik | Assistant Behavior Analyst | 7011 Campus Drive Suite 205, Colorado Springs, CO 80920 | 2018-09-14 |
| 1811473861 | Vsb Colorado Providers Pllc | Dentist | 1750 Telstar Drive, Suite 200, Colorado Springs, CO 80920 | 2018-07-12 |
| 1336637438 | Children's Hospital Colorado | General Acute Care Hospital | 4090 Briargate Parkway, Colorado Springs, CO 80920 | 2018-04-25 |
| Find all providers in zip 80920 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457846685 | E Dawn Martin Caciii LLC | Clinic/Center | 2105 E Bijou St, Colorado Springs, CO 80909-5954 | 2018-06-29 |
| 1205326428 | E Dawn Martin Caciii LLC | Clinic/Center | 2105 E Bijou St Ste B, Colorado Springs, CO 80909-5955 | 2018-05-14 |
| 1902357551 | Peaks Recovery Services | Clinic/Center | 5475 Mark Dabling Blvd Ste 102, Colorado Springs, CO 80918-3847 | 2016-10-19 |
| 1659307312 | Valley Hope Association | Clinic/Center | 888 Garden of The Gods Rd, Ste 101, Colorado Springs, CO 80907-9437 | 2006-06-24 |
| 1023620440 | Peer Coach Academy Colorado | Clinic/Center | 1102 S 21st St, Colorado Springs, CO 80904-3708 | 2020-08-18 |
| 1487263489 | Aspenridge Colorado Springs LLC | Clinic/Center | 2860 S Circle Dr Ste G30a, Colorado Springs, CO 80906-4113 | 2020-07-24 |
| 1528603008 | Aspenpointe, Inc. Dba Aspenpointe Health Services | Clinic/Center | 1795 Jet Wing Dr, Colorado Springs, CO 80916-2332 | 2019-11-08 |
| 1801431382 | Aspenpointe Inc Dba Aspenpointe Health Services | Clinic/Center | 179 S Parkside Dr, Colorado Springs, CO 80910-3130 | 2019-11-08 |
| 1427693902 | Aspenpointe Inc. Dba Aspenpointe Health Services | Clinic/Center | 220 Ruskin Dr, Colorado Springs, CO 80910-2522 | 2019-11-08 |
| 1376188847 | Aspenpointe Inc Dba Health Services | Clinic/Center | 875 W Moreno Ave, Colorado Springs, CO 80905-1731 | 2019-11-08 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80920 |
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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.