Organization
SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC
Active
Organization
SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC
Active
Other names
Shadow Mountain Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE KISTLER CEO (CHIEF EXECUTIVE OFFICER)
(918) 492-8200
Entity
Organization
Contact information
Practice address
6262 S SHERIDAN RD, TULSA, OK 74133-4055
(918) 492-8200
(918) 493-3268
Mailing address
6262 S SHERIDAN ROAD, TULSA, OK 74133-4055
(918) 492-8200
(918) 493-3268
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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