# SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124037288
- **Authorized official:** MRS. SHARON WORSHAM (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (918) 492-8200

## Contact information

- **Practice address:** 6262 S SHERIDAN RD, TULSA, OK 74133-4055
- **Practice address phone:** (918) 492-8200
- **Practice address fax:** (918) 493-3268
- **Mailing address:** 6262 S SHERIDAN RD, TULSA, OK 74133-4055
- **Mailing address phone:** (918) 492-8200
- **Mailing address fax:** (918) 493-3268

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | OK | Yes |

## Other

- **Enumeration date:** 08/07/2006
- **Last updated:** 07/21/2022