NPIMap

Organization Active NPI

Shadow Mountain Behavioral Health System, LLC

  • Psychiatric Residential Treatment Facility
  • Tulsa, OK
National Provider Identifier
1285867713
Registry record updated Sep 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC
Practice address
4012 E 35TH St
Tulsa, OK 74135-4528
Phone
(918) 492-8200
Fax
(918) 493-3268
NPI assigned
Sep 1, 2009
Organization subpart
Yes
Parent organization
PSYCHIATRIC SOLUTIONS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mike Kistler
Title
Chief Executive Officer
Phone
(918) 492-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

4012 E 35TH St
Tulsa, OK 74135-4528

Mailing address

6262 S Sheridan Rd
Tulsa, OK 74133-4055
Phone (918) 492-8200

Other names 1

  • Shadow Mountain Behavioral Health System Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shadow Mountain Behavioral Health System15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251763200000",
    "number": "1285867713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 S SHERIDAN RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334055",
            "telephone_number": "918-492-8200",
            "fax_number": "918-493-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 E 35TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741354528",
            "telephone_number": "918-492-8200",
            "fax_number": "918-493-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PSYCHIATRIC SOLUTIONS INC",
        "enumeration_date": "2009-09-01",
        "last_updated": "2009-09-01",
        "status": "A",
        "authorized_official_last_name": "KISTLER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "918-492-8200"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shadow Mountain Behavioral Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.