Organization
PRAIRIE HILLS RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA ROSE ANDERSON LAC (OWNER/LAC)
(406) 488-3001
Entity
Organization
Contact information
Practice address
623 N CENTRAL AVE, SIDNEY, MT 59270-4216
(406) 488-3001
(406) 488-3003
Mailing address
PO BOX 626, SIDNEY, MT 59270-0626
(406) 488-3001
(406) 488-3003
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2647
LICENSED ADDICTION COUNSELOR CERTIFICATE
MT
05
—
307
—
MT
Enumeration date
06/09/2017
Last updated
06/26/2017
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