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SHADOW MOUNTAIN RECOVERY, UNIVERSITY PARK
NPI 1164896197
Substance Abuse Rehabilitation Facility in Colorado Springs, CO

Active since November 13, 2015
2102 UNIVERSITY PARK BLVD., COLORADO SPRINGS, CO 80918(719) 266-8876 Get Directions Write a Review

NPPES record last updated: April 27, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 27, 2017, Nov 13, 2015 (2 updates tracked since 2015).

About Shadow Mountain Recovery, University Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHADOW MOUNTAIN RECOVERY, UNIVERSITY PARK (NPI 1164896197) is a healthcare organization registered as a substance abuse rehabilitation facility in Colorado Springs, Colorado and active in the NPI registry since November 2015. The organization lists Jackie Holub, Vice President, as its authorized official.

NPPES Registry Identity

NPI1164896197
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameSHADOW MOUNTAIN LLC.
Location Address2102 UNIVERSITY PARK BLVD.Colorado Springs, CO 80918
Mailing AddressPo Box 830525, Dpeartment # Sf 59Birmingham, AL 35283-0525 · (931) 451-7757 · Fax (931) 933-7762
Phone(719) 266-8876
Organization SubpartNo
Authorized OfficialJackie HolubVice President · (925) 389-8591
Enumeration DateNovember 13, 2015
Last NPPES UpdateApril 27, 20172 updates tracked since enumeration
✔ NPI 1164896197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

2102 UNIVERSITY PARK BLVD., Colorado Springs, CO 80918
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Other Names 1

Doing Business AsShadow Mountain Recovery, University Park

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shadow Mountain LLC.'s NPI number?

The NPI number for Shadow Mountain LLC. is 1164896197. It was assigned to this organization in the NPPES registry on November 13, 2015. The provider is doing business as Shadow Mountain Recovery, University Park.

Where is Shadow Mountain LLC. located?

Shadow Mountain LLC. is located at 2102 University Park Blvd., Colorado Springs, CO 80918. The listed phone number is (719) 266-8876.

What is Shadow Mountain LLC.'s specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Shadow Mountain LLC. was last updated on April 27, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.