NPI 1316091457

Shadow Mountain Behavioral Health System LLC

Organisation Psychiatric Residential Treatment Facility Tulsa, OK

Practice location

Address: 1027 E 66th Pl, Tulsa, OK 74136-3701
Phone: (918) 293-2552

Authorised official

Name: Mike Kistler
Title: Ceo
Phone: (918) 492-8200

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X Licence K8500227 (OK)

Other Psychiatric Residential Treatment Facility providers in Oklahoma →

Registry record

NPI: 1316091457
Entity type: Organization
NPI issued: 23 Jan 2007
Record last updated: 30 Mar 2010

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.