Organization
SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC
Active
Other names
Shadow Mountain Behavioral Health System at Eagle Creek
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE KISTLER (CEO)
(918) 492-8200
Entity
Organization
Contact information
Practice address
6262 S SHERIDAN RD, TULSA, OK 74133-4055
(918) 597-3623
Mailing address
6262 S SHERIDAN RD, TULSA, OK 74133-4055
(918) 492-8200
(918) 493-3268
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/10/2007
Last updated
08/22/2020
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