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PETTY CREEK RANCH LLC NPI 1417581125


NPI Information

NPI: 1417581125
Provider Name: PETTY CREEK RANCH LLC
Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
Entity Type: Organization

Specialization: Substance Abuse Treatment, Children

CLIA Number: 27D2187764

Address:
2161 PETTY CREEK RD
ALBERTON, MT
ZIP 59820
Phone: (406) 722-3226
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PETTY CREEK RANCH LLC is a substance abuse treatment and children substance abuse rehabilitation facility in Alberton, MT. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. PETTY CREEK RANCH LLC NPI is 1417581125. The provider is registered as an organization entity type.

The provider's business location address is:

2161 PETTY CREEK RD
ALBERTON, MT
ZIP 59820-401
Phone: (406) 722-3226

The provider's authorized official is Michael Pollard Morso .
The authorized official title is Ceo and has the following contact phone number (307) 254-4191.

The CLIA number assigned to this NPI record is 27D2187764 - other - residential treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/3/2020 and was last updated on 3/3/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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