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Organization
HIGH COUNTRY BEHAVIORAL HEALTH
Active
Organization
HIGH COUNTRY BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIPP DANA LAT, LPC (EXECUTIVE DIRECTOR)
(307) 885-9883
Entity
Organization
Contact information
Practice address
830 HIGHWAY 150 S, EVANSTON, WY 82930-5341
(307) 789-4224
(307) 789-4225
Mailing address
830 HIGHWAY 150 S, EVANSTON, WY 82930-5341
(307) 789-4224
(307) 789-4225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
02/14/2012
Last updated
06/08/2022
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