| NPI | 1487226031 |
|---|---|
| Other Name | SHADOW MOUNTAIN RECOVERY OUTPATIENT, ALBUQUERQUE |
| Entity Type | Organization |
| Authorized Contact | JACKIE HOLUB VP, Operations 925-389-8591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2021-07-13 |