SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC


Address: 2801 Venture Dr, Norman, OK 73069-8215
Phone: 4054479498

SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC (NPI# 1841304250) 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) 1841304250
Entity Type Organization
Organization Name SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC
Other Organization Name SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM
Practice Address 2801 Venture Dr
Norman
OK 73069-8215
Mailing Address 6262 S Sheridan Rd
Tulsa
OK 74133-4055
Practice Telephone 4054479498
Practice Fax Number 4054471911
Mailing Telephone 9184928200
Mailing Fax Number 9184933268
Enumeration Date 2006-08-19
Last Update Date 2020-08-22
Authorized Official Name SHARON WORSHAM (CHIEF EXECUTIVE OFFICER)
Authorized Official Telephone 9184928200
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children K8500225 OK Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
Shadow Mountain Behavioral Health System Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1316056534 Shadow Mountain Behavioral Health System, LLC Clinic/Center 5350 S Western Ave, Suite 555`, Oklahoma City, OK 73109-4520 2006-08-30
1982005971 Shadow Mountain Behavioral Health System, LLC Psychiatric Hospital 6262 S Sheridan Rd, Tulsa, OK 74133-4055 2014-09-09
1902224801 Shadow Mountain Behavioral Health System, LLC Psychiatric Hospital 6262 S Sheridan Rd, Tulsa, OK 74133-4055 2014-03-29
1184941148 Shadow Mountain Behavioral Health System, LLC Psychiatric Residential Treatment Facility 6262 S Sheridan Rd, Tulsa, OK 74133-4055 2010-04-29
1528383841 Shadow Mountain Behavioral Health System, LLC Pharmacy 1027 E 66th Pl, Tulsa, OK 74136-3701 2010-03-30
1285867713 Shadow Mountain Behavioral Health System, LLC Psychiatric Residential Treatment Facility 4012 E 35th St, Tulsa, OK 74135-4528 2009-09-01
1831304351 Shadow Mountain Behavioral Health System, LLC Psychiatric Residential Treatment Facility 6262 S Sheridan Rd, Tulsa, OK 74133-4055 2007-05-10
1740384049 Shadow Mountain Behavioral Health System, LLC Clinic/Center 6125 S Sheridan Rd, Suite D, Tulsa, OK 74133-4056 2006-09-08
1659475952 Shadow Mountain Behavioral Health System, LLC Clinic/Center 6262 S Sheridan Rd, Tulsa, OK 74133-4055 2006-09-08
1003923442 Shadow Mountain Behavioral Health System, LLC Psychiatric Residential Treatment Facility 6262 S Sheridan Rd, Tulsa, OK 74133-4055 2006-08-23

Other Data Sources

Entity Type Entity Name Entity Address
Oklahoma Business Registrations SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC 367 S. Gulph Road, King of Prussia, PA 19406

Office Location

Street Address 2801 VENTURE DR
City NORMAN
State OK
Zip Code 73069-8215

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437719762 Assyria Bayones Case Manager/Care Coordinator 2801 Venture Dr, Norman, OK 73069-8215 2019-06-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235739764 Pinnacle Family Health Care Family Medicine 2781 Washington Drive, Suite 101, Norman, OK 73069 2020-10-26
1063030088 Kristal Ladawn Vasquez Nurse Practitioner 4019 North Flood Ave, Normam, OK 73069 2020-07-07
1841828290 Cheryl Renee Stoepker Nurse Practitioner 3441 24th Ave Nw, Norman, OK 73069 2020-03-31
1427689215 Bodyworx Primary Care, LLC Nurse Practitioner 4019 N Flood Ave, Norman, OK 73069 2020-01-30
1528539376 Monika Potdar Pharmacist 2550 Mount Williams Dr, Norman, OK 73069 2018-12-05
1861962193 Bethany Spring Browne Physician Assistant 209 Hal Muldrow Dr, Apt 7, Norman, OK 73069 2018-11-29
1528536109 Summit Health and Wellness Center LLC Counselor 2770 Washington Dr, Suite 100, Norman, OK 73069 2018-11-13
1386121960 Sarah Lawhead Case Manager/Care Coordinator 525 Dakota St, Norman, OK 73069 2018-07-25
1528554433 Katie Blankenship Occupational Therapist 330 W Grey Street 100-2, Norman, OK 73069 2018-07-03
1568918886 Brandi Deerinwater Case Manager/Care Coordinator 321 S Peters, Norman, OK 73069 2016-08-28
Find all providers in zip 73069

Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437251576 Oklahoma Families First Inc. Residential Treatment Facility, Emotionally Disturbed Children 2227 W Lindsey St Ste 1550, Norman, OK 73069-4075 2006-09-01
1669869145 Cbh of Norman Operating, LLC Residential Treatment Facility, Emotionally Disturbed Children 3400 Deskin Dr, Norman, OK 73069-8295 2015-04-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1417593344 Oklahoma Families First Inc Residential Treatment Facility, Emotionally Disturbed Children 2504 E 71st St Ste A, Tulsa, OK 74136-5504 2019-11-26
1316228414 Briggs Therapeutic Intensive Child Devopment Services Inc. Residential Treatment Facility, Emotionally Disturbed Children 425 S Fretz Ave Ste E, Edmond, OK 73003-5568 2011-09-01
1881872166 Wesleyan Youth Inc. Residential Treatment Facility, Emotionally Disturbed Children One Mile West of Highway 69 On Highway 9 (south Side), Eufaula, OK 74432 2008-02-08
1790963445 Wesleyan Youth Inc. Residential Treatment Facility, Emotionally Disturbed Children 605 Sw B Ave, #3, Lawton, OK 73501-3962 2008-02-05
1730203951 Red Rock Behavorial Health Services Residential Treatment Facility, Emotionally Disturbed Children 4404 N. Lincoln Blvd, Oklahoma City, OK 73105 2007-03-16
1164590790 Cimarron Valley Therapeutic Service, Inc. Residential Treatment Facility, Emotionally Disturbed Children 1005 9th St, Woodward, OK 73801-3131 2006-12-01
1134765068 Oklahoma Families First Inc Residential Treatment Facility, Emotionally Disturbed Children 1301 Kiowa St, Ardmore, OK 73401-2280 2019-11-26
1649816802 Oklahoma Families First Inc Residential Treatment Facility, Emotionally Disturbed Children 1705 Cradduck Rd, Ada, OK 74820-9491 2019-11-22
1275083867 Oklahoma Families First, Inc Residential Treatment Facility, Emotionally Disturbed Children 2526 E 71st St, Ste A, Tulsa, OK 74136-5538 2016-10-07
1265982854 Oklahoma Families First, Inc Residential Treatment Facility, Emotionally Disturbed Children 1705 Cradduck Rd, Ada, OK 74820-9491 2016-10-07
Find all providers with the same taxonomy

Competitor

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City NORMAN
Zip Code 73069

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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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