| NPI | 1760621007 |
|---|---|
| Doing Business As | SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE |
| Entity Type | Organization |
| Authorized Contact | JACKIE HOLUB Managing Director 925-389-8591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2015-10-28 |