Organization
SHADOW MOUNTAIN LLC.
Active
Other names
Shadow Mountain Recovery, Albuquerque
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE HOLUB (MANAGING DIRECTOR)
(925) 389-8591
Entity
Organization
Contact information
Practice address
5400 GIBSON BLVD. S. E, 3RD FLOOR, ALBUQUERQUE, NM 87109
(505) 296-8184
Mailing address
5400 GIBSON BLVD. S.E, 3RD FLOOR, ALBUQUERQUE, NM 87109
(505) 867-0214
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/10/2009
Last updated
10/28/2015
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