Organization
YELLOWSTONE BOYS AND GIRLS RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE CHAVERS (CEO)
(406) 655-2109
Entity
Organization
Contact information
Practice address
1732 S 72ND ST W, BILLINGS, MT 59106-3500
(406) 655-2100
(406) 651-2783
Mailing address
1732 S 72ND ST W, BILLINGS, MT 59106-3500
(406) 655-2100
(406) 651-2783
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
10810
MT
323P00000X
Psychiatric Residential Treatment Facility
10810
MT
363LF0000X
Family Nurse Practitioner
—
—
364S00000X
Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4104880
—
MT
Enumeration date
11/20/2006
Last updated
03/23/2017
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