Organization
SHADOW MOUNTAIN RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ELIZABETH LEVATINO (DIRECTOR OF AR)
(615) 299-6661
Entity
Organization
Contact information
Practice address
1155 KELLY JOHNSON BLVD, COLORADO SPRINGS, CO 80920-3932
(615) 299-6661
Mailing address
1155 KELLY JOHNSON BLVD, COLORADO SPRINGS, CO 80920-3932
(615) 299-6661
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
CO
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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