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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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Substance Abuse Disorder Rehabilitation Facility |
324500000X |
| NPI # | 1154733558 |
| LBN Legal business name | SHADOW MOUNTAIN LLC. |
| Authorized official | JACKIE HOLUB - (VICE PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/20/2014 |
| Last updated | 04/27/2017 - About 9 years ago |
| Identifiers | n/a |
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SHADOW MOUNTAIN LLC.