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SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE
NPI 1760621007
Substance Abuse Rehabilitation Facility in Albuquerque, NM

Active since February 10, 2009
5400 GIBSON BLVD. S. E, 3RD FLOOR, ALBUQUERQUE, NM 87109(505) 296-8184 Get Directions Write a Review

NPPES record last updated: October 28, 2015. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Shadow Mountain Recovery, Albuquerque NPPES

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

SHADOW MOUNTAIN RECOVERY, ALBUQUERQUE (NPI 1760621007) is a healthcare organization registered as a substance abuse rehabilitation facility in Albuquerque, New Mexico and active in the NPI registry since February 2009. The organization lists Jackie Holub, Managing Director, as its authorized official.

NPPES Registry Identity

NPI1760621007
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameSHADOW MOUNTAIN LLC.
Location Address5400 GIBSON BLVD. S. E, 3RD FLOORAlbuquerque, NM 87109
Mailing Address5400 Gibson Blvd. S.e, 3rd FloorAlbuquerque, NM 87109 · (505) 867-0214
Phone(505) 296-8184
Organization SubpartNo
Authorized OfficialJackie HolubManaging Director · (925) 389-8591
Enumeration DateFebruary 10, 2009
Last NPPES UpdateOctober 28, 2015
✔ NPI 1760621007 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.
5400 GIBSON BLVD. S. E, Albuquerque, NM 87109
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Other Names 1

Doing Business AsShadow Mountain Recovery, Albuquerque

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 1760621007. It was assigned to this organization in the NPPES registry on February 10, 2009. The provider is doing business as Shadow Mountain Recovery, Albuquerque.

Where is Shadow Mountain LLC. located?

Shadow Mountain LLC. is located at 5400 Gibson Blvd. S. E 3rd Floor, Albuquerque, NM 87109. The listed phone number is (505) 296-8184.

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 October 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.