SHADOW MOUNTAIN LLC.
Residential Treatment Facilities in Ranchito, NM

License number
New Mexico STATE WAIVER
Category
Residential Treatment Facilities
Type
Substance Abuse Rehabilitation Facility
Owner
Name: JACKIE HOLUB
Title: VICE PRESIDENT
Phone: (925) 389-8591
Address
Address 2
250 Shadow Mountain Rd., Ranchito, NM 87571
830525 Department #SF 57, Birmingham, AL 35283
National Provider ID: 1295154888
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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