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Organization

HIGH COUNTRY BEHAVIORAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY M KLEEMAN (EXECUTIVE ASSISTANT)
(307) 885-9883
Entity
Organization

Contact information

Practice address
34 POWDER RIVER COURT, EVANSTON, WY 82930-5371
(307) 789-4224
(307) 789-4225
Mailing address
34 POWDER RIVER COURT, EVANSTON, WY 82930-5371
(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
WY
291U00000X
Clinical Medical Laboratory
320800000X
Mental Illness Community Based Residential Treatment Facility
WY

Other

Enumeration date
01/24/2012
Last updated
06/08/2022
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