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