NPIMap

Organization Active NPI

Shadow Mountain Recovery

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Colorado Springs, CO
National Provider Identifier
1346787181
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SHADOW MOUNTAIN RECOVERY
Practice address
1155 Kelly Johnson Blvd
Colorado Springs, CO 80920-3932
Phone
(615) 299-6661
NPI assigned
Jan 31, 2017
Last updated
Jan 31, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Authorized official

Name
Mrs. Mary Elizabeth Levatino
Title
Director of Ar
Phone
(615) 299-6661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X CO Primary

Addresses

Primary practice location

1155 Kelly Johnson Blvd
Colorado Springs, CO 80920-3932

Mailing address

1155 Kelly Johnson Blvd
Colorado Springs, CO 80920-3932
Phone (615) 299-6661

National Provider Directory

National Provider Directory
Tax ID family
Shadow Mountain LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

1155 Kelly Johnson Blvd
Colorado Springs, CO 80920
Phone (719) 354-2582

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485820800000",
    "number": "1346787181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 KELLY JOHNSON BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203932",
            "telephone_number": "615-299-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 KELLY JOHNSON BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203932",
            "telephone_number": "615-299-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW MOUNTAIN RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-01-31",
        "status": "A",
        "authorized_official_last_name": "LEVATINO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR OF AR",
        "authorized_official_telephone_number": "615-299-6661",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.