Healthcare Provider Details

I. General information

NPI: 1083597769
Provider Name (Legal Business Name): STEAMBOAT HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 E 3RD ST
GILLETTE WY
82716-4023
US

IV. Provider business mailing address

902 E 3RD ST
GILLETTE WY
82716-4023
US

V. Phone/Fax

Practice location:
  • Phone: 307-756-9200
  • Fax:
Mailing address:
  • Phone: 307-756-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AMBER L TUELLER
Title or Position: SECRETARY
Credential:
Phone: 208-207-2726