Organization
SHADOW MOUNTAIN RECOVERY LLC.
Active
Other names
Shadow Mountain Recovery, Rio Rancho, Shadow Mountain Recovery, Santa Fe, Shadow Mountain Recovery, Albuquerque
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACKIE ELLIOTT (VICE PRESIDENT)
(925) 389-8591
Entity
Organization
Contact information
Practice address
1114 VILLA RD SE, RIO RANCHO, NM 87124-3581
(800) 203-8249
Mailing address
PO BOX 830525, DEPARTMENT # SF 64, BIRMINGHAM, AL 35283-0525
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/28/2015
Last updated
04/06/2021
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