Healthcare Provider Details

I. General information

NPI: 1720501570
Provider Name (Legal Business Name): YELLOWSTONE BOYS AND GIRLS RANCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2017
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1732 S 72ND ST W
BILLINGS MT
59106
US

IV. Provider business mailing address

1700 S 72ND ST W
BILLINGS MT
59106-3538
US

V. Phone/Fax

Practice location:
  • Phone: 406-655-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MIKE CHAVERS
Title or Position: CEO
Credential:
Phone: 406-655-2100