Organization · NPI-2

High Country Behavioral Health

Clinic/Center, Mental Health (Including Community Mental Health Center) · Evanston, WY

NPI number1942571807

StatusActive

Last updated in NPPESJun 8, 2022

Details

NPI: 1942571807
Entity type: Organization (NPI-2)
Legal business name: High Country Behavioral Health
Organization subpart: No
Enumeration date: Jan 24, 2012
Certification date: Jun 8, 2022
Last updated: Jun 8, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	WY	Yes
207Q00000X	Family Medicine	–	–
207QA0401X	Family Medicine, Addiction Medicine	–	–
291U00000X	Clinical Medical Laboratory	–	–
320800000X	Community Based Residential Treatment Facility, Mental Illness	–	WY

Practice location

34 Powder River Court
Evanston, WY 82930-5371

Phone 307-789-4224 · Fax 307-789-4225

Mailing address

34 Powder River Court
Evanston, WY 82930-5371

Phone 307-789-4224 · Fax 307-789-4225

Authorized official

Kelly M Kleeman
Executive Assistant
3078859883

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