# SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shadow Mountain Behavioral Health System
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841304250
- **Authorized official:** SHARON WORSHAM (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (918) 492-8200

## Contact information

- **Practice address:** 2801 VENTURE DR, NORMAN, OK 73069-8215
- **Practice address phone:** (405) 447-9498
- **Practice address fax:** (405) 447-1911
- **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 |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | K8500225 | OK | Yes |

## Other

- **Enumeration date:** 08/19/2006
- **Last updated:** 08/22/2020