SHADOW MOUNTAIN LLC.
NPI: 1295154888
· TAOS, NM 87571
· Substance Abuse Rehabilitation Facility
· NPI assigned 04/10/2014
Provider Details
| Authorized Official | HOLUB, JACKIE (VICE PRESIDENT) |
| NPI Enumeration Date | 04/10/2014 |
Related Entities
Other providers sharing the same authorized official: HOLUB, JACKIE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
59 |
$32K |
| 2024 |
168 |
$51K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0018 |
Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem |
227 |
27 |
$83K |