Healthcare Provider Details
I. General information
NPI: 1821208208
Provider Name (Legal Business Name): MICHAEL JAMES GEBOE LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/23/2007
Last Update Date: 07/02/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
ROCKY BOY HEALTH CENTER 6850 UPPER BOX ELDER RD
BOX ELDER MT
59521-9797
US
IV. Provider business mailing address
146 ELSIES CIR
BOX ELDER MT
59521-8899
US
V. Phone/Fax
- Phone: 406-395-4486
- Fax:
- Phone: 406-390-4749
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | BBH-LAC-LIC-1082 |
| License Number State | MT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | BBH-BHPS-CRT-78947 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: