NPI 1821105263

Shadow Mountain Behavioral Health System, LLC

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Tulsa, OK

Practice location

Address: 6125 S Sheridan Rd Suite D, Tulsa, OK 74133-4056
Phone: (918) 585-3083
Fax: (918) 492-2075
Mailing address: 6262 S Sheridan Rd, Tulsa, OK 74133-4055

Authorised official

Name: Sharon Worsham
Title: Chief Executive Officer
Phone: (918) 492-8200

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence K8600196 (OK)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Oklahoma →

Registry record

NPI: 1821105263
Entity type: Organization
NPI issued: 23 Aug 2006
Record last updated: 22 Aug 2020

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.