| NPI | 1164896197 |
|---|---|
| Doing Business As | SHADOW MOUNTAIN RECOVERY, UNIVERSITY PARK |
| Entity Type | Organization |
| Authorized Contact | JACKIE HOLUB Vice President 925-389-8591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2017-04-27 |