NPI 1154733558

Shadow Mountain LLC.

Organisation Substance Abuse Rehabilitation Facility Cascade, CO

Practice location

Address: 5250 Pikes Peak Highway, Cascade, CO 80809
Phone: (719) 684-7846
Fax: (719) 684-7841
Mailing address: PO Box 830525 Department # Sf 56, Birmingham, AL 35283-0525

Authorised official

Name: Jackie Holub
Title: Vice President
Phone: (925) 389-8591

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

Other Substance Abuse Rehabilitation Facility providers in Colorado →

Registry record

NPI: 1154733558
Entity type: Organization
NPI issued: 20 May 2014
Record last updated: 27 Apr 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.