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SHADOW MOUNTAIN RECOVERY, COLORADO SPRINGS
NPI 1801226709
Substance Abuse Rehabilitation Facility in Colorado Springs, CO

Active since November 14, 2013
1155 KELLY JOHNSON BLVD, SUITE 201, COLORADO SPRINGS, CO 80920(719) 418-3737 Get Directions Write a Review

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

Record update history: Feb 27, 2017, Dec 10, 2015 (2 updates tracked since 2015).

About Shadow Mountain Recovery, Colorado Springs NPPES

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

SHADOW MOUNTAIN RECOVERY, COLORADO SPRINGS (NPI 1801226709) is a healthcare organization registered as a substance abuse rehabilitation facility in Colorado Springs, Colorado and active in the NPI registry since November 2013. The organization lists Jackie Holub, Vice President, as its authorized official.

NPPES Registry Identity

NPI1801226709
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameSHADOW MOUNTAIN LLC.
Location Address1155 KELLY JOHNSON BLVD, SUITE 201Colorado Springs, CO 80920-3932
Mailing AddressPo Box 830525, Department # Sf 58Birmingham, AL 35283-0525 · (931) 451-7757 · Fax (931) 933-7762
Phone(719) 418-3737
Organization SubpartNo
Authorized OfficialJackie HolubVice President · (925) 389-8591
Enumeration DateNovember 14, 2013
Last NPPES UpdateFebruary 27, 20172 updates tracked since enumeration
✔ NPI 1801226709 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X · License 1746-01 (CO)
1155 KELLY JOHNSON BLVD, Colorado Springs, CO 80920
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Other Names 1

Doing Business AsShadow Mountain Recovery, Colorado Springs

Other Providers at the Same Location NPPES 18

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

DR. SCOTT ALLAN DRAPER D.D.S., M.S.
Dentist (Prosthodontics)
1155 KELLY JOHNSON BLVD, SUITE 210
COLORADO SPRINGS, CO 80920
El Paso County (719) 532-1007
LYNN M GILBERT
Behavior Technician
1155 KELLY JOHNSON BLVD
COLORADO SPRINGS, CO 80920
El Paso County (719) 415-7022
CAITLYN CANFIELD
Behavior Analyst
1155 KELLY JOHNSON BLVD, 150
COLORADO SPRINGS, CO 80920
El Paso County (719) 354-2582
SHADOW MOUNTAIN RECOVERY
Clinic/Center (Rehabilitation, Substance Use Disorder)
1155 KELLY JOHNSON BLVD
COLORADO SPRINGS, CO 80920
El Paso County (615) 299-6661
DR. BRUCE JOHN ZIMMERMAN DDS
Dentist
1155 KELLY JOHNSON BLVD, SUITE 210
COLORADO SPRINGS, CO 80920
El Paso County (719) 593-9100
HOME HEALTHCARE SERVICES OF THE ROCKIES INC
Home Health
1155 KELLY JOHNSON BLVD, SUITE 111
COLORADO SPRINGS, CO 80920
El Paso County (719) 590-4132
HAVEN CORPORATION
Community/Behavioral Health
1155 KELLY JOHNSON BLVD, SUITE 111
COLORADO SPRINGS, CO 80920
El Paso County (719) 590-4124
JANESSA YBARRA
Behavior Technician
1155 KELLY JOHNSON BLVD
COLORADO SPRINGS, CO 80920
El Paso County (719) 691-0126

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 1801226709. It was assigned to this organization in the NPPES registry on November 14, 2013. The provider is doing business as Shadow Mountain Recovery, Colorado Springs.

Where is Shadow Mountain LLC. located?

Shadow Mountain LLC. is located at 1155 Kelly Johnson Blvd Suite 201, Colorado Springs, CO 80920. The listed phone number is (719) 418-3737.

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 February 27, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.