SHADOW MOUNTAIN LLC. (NPI# 1801226709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801226709 |
| Entity Type | Organization |
| Organization Name | SHADOW MOUNTAIN LLC. |
| Other Organization Name | SHADOW MOUNTAIN RECOVERY, COLORADO SPRINGS |
| Practice Address |
1155 Kelly Johnson Blvd Suite 201 Colorado Springs CO 80920-3932 |
| Mailing Address |
Po Box 830525 Department # Sf 58 Birmingham AL 35283-0525 |
| Practice Telephone | 7194183737 |
| Mailing Telephone | 9314517757 |
| Mailing Fax Number | 9319337762 |
| Enumeration Date | 2013-11-14 |
| 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 |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 1746-01 | CO | Agencies |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Shadow Mountain Recovery, Colorado Springs | 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 |
| 1437521507 | Shadow Mountain LLC. | Substance Abuse Rehabilitation Facility | 5400 Gibson Blvd Se, Third Floor, Suite A, Albuquerque, NM 87108-4729 | 2015-10-28 |
| Street Address |
1155 KELLY JOHNSON BLVD SUITE 201 |
| 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 |
| 1346787181 | Shadow Mountain Recovery | Clinic/Center | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2017-01-31 |
| 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 |
| 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 | 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 |
|---|---|---|---|---|
| 1174069223 | Courage To Change | Substance Abuse Rehabilitation Facility | 3470 Briargate Blvd, Colorado Springs, CO 80920-4168 | 2017-01-12 |
| 1487028577 | Crossroads' Turning Points, Inc. | Substance Abuse Rehabilitation Facility | 411 S Cascade Ave, Colorado Springs, CO 80903-3809 | 2015-11-30 |
| 1164896197 | Shadow Mountain LLC. | Substance Abuse Rehabilitation Facility | 2102 University Park Blvd., Colorado Springs, CO 80918 | 2015-11-13 |
| 1922434182 | El Paso County Community Detox Facility | Substance Abuse Rehabilitation Facility | 2723 E. Las Vegas St., Colorado Springs, CO 80906 | 2013-09-19 |
| 1801418660 | Crossroads' Turning Points, Inc. | Substance Abuse Rehabilitation Facility | 1026 Maxwell St, Colorado Springs, CO 80906-5554 | 2020-05-14 |
| 1275076283 | Serenity Peaks Recovery Center | Substance Abuse Rehabilitation Facility | 2270 La Montana Way, Suite 100, Colorado Springs, CO 80918-6715 | 2016-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336071 | Sobriety House, Inc. | Substance Abuse Rehabilitation Facility | 1368 Elizabeth St, Denver, CO 80206-2309 | 2020-11-06 |
| 1548874308 | Lotus Lodge, LLC | Substance Abuse Rehabilitation Facility | 206 Uvalda St, Aurora, CO 80011-8602 | 2020-08-31 |
| 1710591573 | Lotus Lodge Men, LLC | Substance Abuse Rehabilitation Facility | 16313 E 7th Dr, Aurora, CO 80011-4524 | 2020-08-31 |
| 1710509583 | Crossroads' Turning Points, Inc. | Substance Abuse Rehabilitation Facility | 1004 Carbon Place, Trinidad, CO 81082 | 2020-05-14 |
| 1538796156 | Rocky Mountain Detox, LLC | Substance Abuse Rehabilitation Facility | 1336 Pierce St, Lakewood, CO 80214-1939 | 2020-03-24 |
| 1215574413 | Healing Pines Recovery, LLC. | Substance Abuse Rehabilitation Facility | 5550 County Road 124, Elizabeth, CO 80107 | 2019-12-06 |
| 1790328607 | Gallus Detox Denver LLC | Substance Abuse Rehabilitation Facility | 5920 S Estes St Ste 150, Littleton, CO 80123-8620 | 2019-10-23 |
| 1114584232 | Scw Recovery LLC | Substance Abuse Rehabilitation Facility | 330 Fiedler Ave, Ste 103, Dillon, CO 80435 | 2019-05-23 |
| 1902462617 | Colorado West Regional Mental Health, Inc. | Substance Abuse Rehabilitation Facility | 2800 Riverside Pkwy Bldg 2, Grand Junction, CO 81501-4721 | 2019-05-17 |
| 1487122057 | Valiant Dtx, LLC | Substance Abuse Rehabilitation Facility | 2602 S Ensenada Way, Aurora, CO 80013-7690 | 2018-11-12 |
| Find all providers with the same taxonomy | ||||
| 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.