Organization · NPI-2

High Country Behavioral Health

Clinic/Center, Recovery Care · Evanston, WY

NPI number1174805402

StatusActive

Last updated in NPPESJun 7, 2024

Details

NPI: 1174805402
Entity type: Organization (NPI-2)
Legal business name: High Country Behavioral Health
Organization subpart: No
Enumeration date: Sep 13, 2011
Certification date: Jun 7, 2024
Last updated: Jun 7, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QR0800X	Clinic/Center, Recovery Care	–	–	Yes
207Q00000X	Family Medicine	–	–
207QA0401X	Family Medicine, Addiction Medicine	–	–
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	LAT-220	WY
291U00000X	Clinical Medical Laboratory	–	–

Practice location

190 Overthrust Rd.
Evanston, WY 82931-2910

Phone 307-789-4224 · Fax 307-789-4225

Mailing address

190 Overthrust Rd.
Evanston, WY 82931-2910

Phone 307-789-4224 · Fax 307-789-4225

Authorized official

Kipp Dana
Executive Director
3078859883

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