Organization
SHADOW MOUNTAIN HEALTH LLC.
Active
Parent organization
SHADOW MOUNTAIN RECOVERY LLC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHADOW MOUNTAIN RECOVERY LLC.
Authorized official
JACKIE ELLIOTT (VP OPERATIONS)
(925) 389-8591
Entity
Organization
Contact information
Practice address
7005 PROSPECT PL NE, ALBUQUERQUE, NM 87110-4311
(925) 389-8591
Mailing address
104 S WAYNE AVE UNIT 371, WAYNE, PA 19087-6026
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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