| Shadow Mountain Behavioral Health Llc. | |
|
1155 Kelly Johnson Blvd Suite 206 Colorado Springs CO 80920-3932 | |
| (719) 229-5990 | |
| Not Available |
| Full Name | Shadow Mountain Behavioral Health Llc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1155 Kelly Johnson Blvd, Colorado Springs, Colorado |
| Authorized Official Name and Position | William Hodson (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7194654121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shadow Mountain Behavioral Health Llc. 1155 Kelly Johnson Blvd Suite 206 Colorado Springs CO 80920-3932 Ph: (719) 229-5990 | Shadow Mountain Behavioral Health Llc. 1155 Kelly Johnson Blvd Suite 206 Colorado Springs CO 80920-3932 Ph: (719) 229-5990 |
| NPI Number | 1831593318 |
|---|---|
| Provider Enumeration Date | 10/13/2014 |
| Last Update Date | 10/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831593318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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