Shadow Mountain LLC.
Organization Active NPI Substance Abuse Rehabilitation Facility · Cascade, CO
NPI 1154733558 · NPPES record last updated Apr 27, 2017
Key facts
- NPI
- 1154733558
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- Legal business name
- SHADOW MOUNTAIN LLC.
- Practice address
- 5250 Pikes Peak Highway
Cascade, CO 80809 - Phone
- (719) 684-7846
- Fax
- (719) 684-7841
- NPI assigned
- May 20, 2014
- Organization subpart
- No
Authorized official
- Name
- Jackie Holub
- Title
- Vice President
- Phone
- (925) 389-8591
Corporate family (same tax ID) 11
National Provider Directory
- Tax ID family
- Shadow Mountain LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Yes |
Addresses
Primary practice location
5250 Pikes Peak Highway
Cascade, CO 80809
Mailing address
PO Box 830525
Department # SF 56
Birmingham, AL 35283-0525
Phone (931) 451-7757
Other names
- Shadow Mountain Recovery, Cascade
Other providers in Cascade, CO
- Cristina Leonhardt
- Cindy Montgomery
- Peak Independence Occupational Therapy and Wellness, LLC
- Amber Nicole Rice
- Sandstone Care Cos, LLC
- Southern Colorado Addiction Recovery Center
- Carlye Spaulding
- Spirited NP, LLC
- Erik Struck
- Erin Sullivan
All providers in Cascade, CO · Substance Abuse Rehabilitation Facility in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.