SHADOW MOUNTAIN LLC.


Address: 5400 Gibson Blvd Se, Third Floor, Suite A, Albuquerque, NM 87108-4729
Phone: 9243898591

SHADOW MOUNTAIN LLC. (NPI# 1437521507) 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) 1437521507
Entity Type Organization
Organization Name SHADOW MOUNTAIN LLC.
Other Organization Name SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE
Practice Address 5400 Gibson Blvd Se
Third Floor, Suite A
Albuquerque
NM 87108-4729
Mailing Address Po Box 830525
Department # Sf 64
Birmingham
AL 35283-0525
Practice Telephone 9243898591
Enumeration Date 2015-10-28
Last Update Date 2017-02-27
Authorized Official Name MS. 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, Albuquerque Doing Business As Name - Organization

Other Provider IDs and Locations

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
1760621007 Shadow Mountain LLC. Substance Abuse Rehabilitation Facility 5400 Gibson Blvd. S. E, 3rd Floor, Albuquerque, NM 87109 2009-02-10
1801226709 Shadow Mountain LLC. Community/Behavioral Health 1155 Kelly Johnson Blvd, Suite 201, Colorado Springs, CO 80920-3932 2013-11-14

Office Location

Street Address 5400 GIBSON BLVD SE
THIRD FLOOR, SUITE A
City ALBUQUERQUE
State NM
Zip Code 87108-4729

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609849975 Jeff Scott Zabel Internal Medicine 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 2006-02-08
1023635299 Khatali Telemed Services Internal Medicine 5400 Gibson Blvd Se, Albuquerque, NM 87108-5566 2020-07-02
1447890033 Hypnos Anesthesia Nurse Anesthetist, Certified Registered 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 2020-01-10
1780155952 Enchantment Anesthesia LLC Nurse Anesthetist, Certified Registered 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 2018-12-16
1275017055 Joseph Fitz Nemeth Nurse Practitioner 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 2018-09-18
1134603186 Jane Van Buskirk Huelsmann Occupational Therapist 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 2018-09-15
1821506882 Michael Len Toon Pharmacist 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 2018-01-11
1952830648 Marjorie S Mock Social Worker 5400 Gibson Blvd Se, 4th Floor, Albuquerque, NM 87108-4729 2017-06-07
1982153466 Nadia Joseph Counselor 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 2016-09-26
1861940983 Jessica Shaw Pharmacist 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 2016-09-18
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1588274393 Aubrey Bunnenberg Behavior Technician 114 Pennsyvlania St. Ne Apt. 1, Albuquerque, NM 87108 2020-08-06
1336757301 Dailey Doss Physician Assistant Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 2020-07-16
1457990046 Christine Lovato Registered Nurse Albuquerque Treatment Services LLC, 123 Madeira Dr Se, Albuquerque, NM 87108 2019-12-30
1265074405 Andrew Jacob Reuter Pharmacist 3816 Copper Ave Ne, Unit A, Albuquerque, NM 87108 2019-10-09
1518517325 Lillian Abeyta Technician 1501 San Pedro Dr Se., Albuquerque, NM 87108 2019-09-13
1962970061 Donald Borrego Occupational Therapy Assistant 5200 Copper Ne, #7, Albuquerque, NM 87108 2018-11-06
1154808012 Catalina Castro Social Worker 209 San Pablo Se, Albuquerque, NM 87108 2018-07-24
1942721048 Walgreen Co Pharmacy 933 San Mateo Blvd Ne Ste 501, Albuquerque, NM 87108 2017-06-29
1467981860 Jennifer Martinez Behavior Technician 628 Espanola Se, Albuquerque, NM 87108 2017-06-08
1457892465 J Dowd Counseling LLC Counselor 514 Monroe Street Se, Albuquerque, NM 87108 2017-03-10
Find all providers in zip 87108

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
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
1760621007 Shadow Mountain LLC. Substance Abuse Rehabilitation Facility 5400 Gibson Blvd. S. E, 3rd Floor, Albuquerque, NM 87109 2009-02-10
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
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

Competitor

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City ALBUQUERQUE
Zip Code 87108

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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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