Shadow Mountain LLC.
NPI 1295154888ActiveOrganization· Substance Abuse Rehabilitation Facility· Taos, NM
Substance Abuse Rehabilitation Facility in Taos, New Mexico, registered in NPPES in April 2014. The authorized official on file is Jackie Holub, Vice President.
Overview
| NPI | 1295154888 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 10, 2014 |
| Last updated in NPPES | May 10, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Substance Abuse Rehabilitation Facility Primary | 324500000X | STATE WAIVER | NM |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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