Shadow Mountain Recovery Llc.

LBN: Shadow Mountain Recovery Llc.
Shadow Mountain Recovery Llc. is an health care organization with primary practice located at 1550 Bridger Rd Ne , Rio Rancho NM 87144-1579. The organization recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as the primary health care specialty. Shadow Mountain Recovery Llc. can be contacted via phone (800) 203-8249, or through Holub, Jackie via phone (925) 389-8591.

Contact Information

Primary practice address
1550 Bridger Rd Ne Rio Rancho NM 87144-1579
Phone: (800) 203-8249
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Holub, Jackie
Phone: (925) 389-8591

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1952973505
LBN Legal business name Shadow Mountain Recovery Llc.
DBA Doing business as
Authorized official Holub, Jackie
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2021
Last updated Jul 13th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952973505 NPPES
New Mexico MEDICAID 15453081

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