Organization
SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC
Active
Other names
Shadow Mountain Behavioral Health System
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON WORSHAM (CHIEF EXECUTIVE OFFICER)
(918) 492-8200
Entity
Organization
Contact information
Practice address
2801 VENTURE DR, NORMAN, OK 73069-8215
(405) 447-9498
(405) 447-1911
Mailing address
6262 S SHERIDAN RD, TULSA, OK 74133-4055
(918) 492-8200
(918) 493-3268
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
K8500225
OK
Other
Enumeration date
08/19/2006
Last updated
08/22/2020
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