Organization
SHADOW MOUNTAIN RECOVERY LLC.
Active
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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