SHADOW MOUNTAIN LLC. (NPI# 1760621007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760621007 |
| Entity Type | Organization |
| Organization Name | SHADOW MOUNTAIN LLC. |
| Other Organization Name | SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE |
| Practice Address |
5400 Gibson Blvd. S. E 3rd Floor Albuquerque NM 87109 |
| Mailing Address |
5400 Gibson Blvd. S.e 3rd Floor Albuquerque NM 87109 |
| Practice Telephone | 5052968184 |
| Mailing Telephone | 5058670214 |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2015-10-28 |
| Authorized Official Name | JACKIE HOLUB (MANAGING DIRECTOR) |
| Authorized Official Telephone | 9253898591 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Shadow Mountain Recovery, Albuquerque | 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 |
| 1295154888 | Shadow Mountain LLC. | Substance Abuse Rehabilitation Facility | 250 Shadow Mountain Rd., Taos, NM 87571 | 2014-04-10 |
| 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 |
5400 GIBSON BLVD. S. E 3RD FLOOR |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1386870137 | Dismas House Nm Inc. | Substance Abuse Rehabilitation Facility | 701 Candelaria Rd Nw, Albuquerque, NM 87107-2407 | 2009-06-08 |
| 1356527162 | Sobriety House | Substance Abuse Rehabilitation Facility | 126 General Chennault St Ne, Albuquerque, NM 87123-2515 | 2008-01-11 |
| 1104982099 | Albuquerque Health Care for The Homeless | Substance Abuse Rehabilitation Facility | 5817 Central Ave Nw, Albuquerque, NM 87105-1800 | 2006-12-28 |
| 1316003213 | Albuquerque Health Care for The Homeless | Substance Abuse Rehabilitation Facility | 502 Los Arboles Avenue Nw, Albuquerque, NM 87107 | 2006-12-28 |
| 1437521507 | Shadow Mountain LLC. | Substance Abuse Rehabilitation Facility | 5400 Gibson Blvd Se, Third Floor, Suite A, Albuquerque, NM 87108-4729 | 2015-10-28 |
| 1962896332 | Dds LLC | Substance Abuse Rehabilitation Facility | 6747 Academy Rd Ne, Suite A, Albuquerque, NM 87109-3384 | 2015-03-24 |
| 1487773792 | The Right Step of Albuquerque | Substance Abuse Rehabilitation Facility | 2625 Pennsylvania St Ne, Suite 500, Albuquerque, NM 87110-3615 | 2007-03-28 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
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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.