Organization
SHADOW MOUNTAIN RECOVERY LLC.
Active
Other names
Shadow Mountain Recovery Outpatient, Albuquerque
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE HOLUB (VP, OPERATIONS)
(925) 389-8591
Entity
Organization
Contact information
Practice address
7005 PROSPECT PL NE, ALBUQUERQUE, NM 87110-4311
(800) 203-8249
Mailing address
7005 PROSPECT PL NE, ALBUQUERQUE, NM 87110-4311
(800) 203-8249
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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