NPI | 1801226709 |
---|---|
Doing Business As | SHADOW MOUNTAIN RECOVERY, COLORADO SPRINGS |
Entity Type | Organization |
Authorized Contact | JACKIE HOLUB Vice President 925-389-8591 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Additional Taxonomies | 251S00000X (Licence: CO 1746-01) |
Enumeration Date | 2013-11-14 |
Last Update Date | 2017-02-27 |