Shadow Mountain LLC.
Shadow Mountain LLC. is a healthcare organization registered as Substance Abuse Rehabilitation Facility in Albuquerque, NM, holding Type 2 (organization) NPI 1760621007 since 2009. The authorized official on file is Jackie Holub, Managing Director.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1760621007 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Shadow Mountain LLC. |
| Other name | <Unavail> |
| Practice address | 5400 GIBSON BLVD. S. E, 3RD FLOOR, Albuquerque, NM, 87109 |
| Phone | 5052968184 |
| Enumeration date | 2009-02-10 |
| Last updated in NPPES | 2015-10-28 |
Authorized official
| Name | Jackie Holub |
|---|---|
| Title | Managing Director |
| Phone | 9253898591 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | Primary | — | — |
Copy-ready billing details
Provider: Shadow Mountain LLC. NPI: 1760621007 Taxonomy: 324500000X (Substance Abuse Rehabilitation Facility) Address: 5400 GIBSON BLVD. S. E, 3RD FLOOR, Albuquerque, NM, 87109
Verify this record
Cross-check NPI 1760621007 against the authoritative CMS record: view Shadow Mountain LLC. on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Shadow Mountain LLC.?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2015-10-28.