NPI 1285867713

Shadow Mountain Behavioral Health System, LLC

Organisation Psychiatric Residential Treatment Facility Tulsa, OK

Practice location

Address: 4012 E 35th St, Tulsa, OK 74135-4528
Phone: (918) 492-8200
Fax: (918) 493-3268
Mailing address: 6262 S Sheridan Rd, Tulsa, OK 74133-4055

Authorised official

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

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X

Other Psychiatric Residential Treatment Facility providers in Oklahoma →

Registry record

NPI: 1285867713
Entity type: Organization
NPI issued: 1 Sep 2009
Record last updated: 1 Sep 2009

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.