Organization
SHADOW MOUNTAIN LLC.
Active
Other names
Shadow Mountain Recovery, Denver
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE HOLUB (VICE PRESIDENT)
(925) 389-8591
Entity
Organization
Contact information
Practice address
8200 E. BELLEVIEW BLVD., SUITE 400E, GREENWOOD VILLAGE, CO 80111
(303) 420-9430
(720) 360-0202
Mailing address
PO BOX 830525, DEPARTMENT # SF 62, BIRMINGHAM, AL 35283-0525
(931) 451-7757
(931) 933-7762
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/14/2014
Last updated
04/26/2017
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