OrganizationActive
Shadow Mountain Health LLC.
NPI 1477208452 · Health Service Clinic/Center · Albuquerque, NM
Provider details
- NPI number
- 1477208452
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Shadow Mountain Recovery LLC.
- Organization subpart
- Yes
- Authorized official
- Jackie Elliott, Vp Operations(925) 389-8591
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7005 Prospect Pl Ne
Albuquerque, NM 87110-4311
Phone: (925) 389-8591
Street-level locationGet directions
Mailing address
104 S Wayne Ave Unit 371
Wayne, PA 19087-6026
Registry dates
- Enumerated
- 2022-02-17
- Last updated
- 2022-02-17
- Certified
- 2022-02-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.