SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM PHARMACY
NPI 1316091457
Psychiatric Residential Treatment Facility in Tulsa, OK

Active since January 23, 2007
1027 E 66TH PL, TULSA, OK 74136(918) 293-2552 Get Directions Write a Review

NPPES record last updated: March 30, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shadow Mountain Behavioral Health System Pharmacy NPPES

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

SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM PHARMACY (NPI 1316091457) is a healthcare organization registered as a psychiatric residential treatment facility in Tulsa, Oklahoma and active in the NPI registry since January 2007. The organization lists Mike Kistler, Ceo, as its authorized official.

NPPES Registry Identity

NPI1316091457
Entity TypeOrganization
Primary Taxonomy323P00000X
Legal Business NameSHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM LLC
Location Address1027 E 66TH PLTulsa, OK 74136-3701
Mailing Address1027 E 66th PlTulsa, OK 74136-3701 · (918) 293-2552
Organization SubpartNo
Authorized OfficialMike KistlerCeo · (918) 492-8200
Enumeration DateJanuary 23, 2007
Last NPPES UpdateMarch 30, 2010
NPI 1316091457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychiatric Residential Treatment FacilityResidential Treatment Facilities
Taxonomy Code323P00000X
License Licensed in OK · K8500227
Definition
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary
1027 E 66TH PL, Tulsa, OK 74136

Other Names 1

Doing Business AsShadow Mountain Behavioral Health System Pharmacy

Other Identifiers 1

Medicaid200006820QOK

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
1027 E 66TH PL
TULSA, OK 74136
Social Worker (Clinical)
1027 E 66TH PL
TULSA, OK 74136
Social Worker (Clinical)
1027 E 66TH PL
TULSA, OK 74136
Pharmacy (Institutional Pharmacy)
1027 E 66TH PL
TULSA, OK 74136
Social Worker (Clinical)
1027 E 66TH PL
TULSA, OK 74136
Psychiatric Residential Treatment Facility
1027 E 66TH PL
TULSA, OK 74136

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 Behavioral Health System LLC's NPI number?

The NPI number for Shadow Mountain Behavioral Health System LLC is 1316091457. It was assigned to this organization in the NPPES registry on January 23, 2007. The provider is doing business as Shadow Mountain Behavioral Health System Pharmacy.

Where is Shadow Mountain Behavioral Health System LLC located?

Shadow Mountain Behavioral Health System LLC is located at 1027 E 66th Pl, Tulsa, OK 74136. The listed phone number is (918) 293-2552.

What is Shadow Mountain Behavioral Health System LLC's specialty?

The primary specialty registered for this NPI is Psychiatric Residential Treatment Facility with taxonomy code 323P00000X.

When was this NPI record last updated?

The NPPES record for Shadow Mountain Behavioral Health System LLC was last updated on March 30, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.