MEDICARE: BIG SKY RECOVERY MENTAL HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1396331179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIG SKY RECOVERY MENTAL HEALTH LLC

Provider Business Mailing Address
First Line	:	PO BOX 5477
Second Line	:
City	:	WHITEFISH
State	:	MT
Zip	:	59937-5477
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	309 WISCONSIN AVE
Second Line	:
City	:	WHITEFISH
State	:	MT
Zip	:	59937-2319
Country	:	US
Telephone Number	:	406-396-0266
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JUSTIN GABLE
Credential	:	LCPC
Telephone Number	:	406-396-0266

Provider Enumeration Date	:	12/16/2020
Last Update Date	:	03/18/2026

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