OrganizationActive
Shadow Mountain LLC.
NPI 1760621007 · Substance Abuse Rehabilitation Facility · Albuquerque, NM
Provider details
- NPI number
- 1760621007
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Jackie Holub, Managing Director(925) 389-8591
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
5400 Gibson Blvd. S. E
3rd Floor
Albuquerque, NM 87109
Phone: (505) 296-8184
Street-level locationGet directions
Mailing address
5400 Gibson Blvd. S.e
Albuquerque, NM 87109
Other names (DBA / former)
- Doing business as
- Shadow Mountain Recovery, Albuquerque
Registry dates
- Enumerated
- 2009-02-10
- Last updated
- 2015-10-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.