Healthcare Provider Details

I. General information

NPI: 1285854885
Provider Name (Legal Business Name): CRYSTAL CREEK LODGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 N PIEGAN ST
BROWNING MT
59417-5217
US

IV. Provider business mailing address

807 N PIEGAN ST
BROWNING MT
59417-5217
US

V. Phone/Fax

Practice location:
  • Phone: 406-338-6330
  • Fax: 406-338-7660
Mailing address:
  • Phone: 406-338-6330
  • Fax: 406-338-7660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK CALF LOOKING
Title or Position: DIRECTOR
Credential: L.A.C.
Phone: 406-338-6330