Healthcare Provider Details

I. General information

NPI: 1306232673
Provider Name (Legal Business Name): YELLOWSTONE BOYS AND GIRLS RANCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1732 S 72ND ST W
BILLINGS MT
59106-3538
US

IV. Provider business mailing address

1732 S 72ND ST W
BILLINGS MT
59106-3538
US

V. Phone/Fax

Practice location:
  • Phone: 406-655-2138
  • Fax:
Mailing address:
  • Phone: 406-655-2138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License NumberSWP-LCPC-LIC-11538
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JAYME ROLL
Title or Position: ADMIN
Credential:
Phone: 406-655-2138