PETTY CREEK RANCH LLC (NPI# 1417581125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417581125 |
| Entity Type | Organization |
| Organization Name | PETTY CREEK RANCH LLC |
| Practice Address |
2161 Petty Creek Rd Alberton MT 59820-9401 |
| Mailing Address |
Po Box 289 Alberton MT 59820-0289 |
| Practice Telephone | 4067223226 |
| Mailing Telephone | 4067223226 |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-03-03 |
| Authorized Official Name | MICHAEL POLLARD MORSO (CEO) |
| Authorized Official Telephone | 3072544191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| Street Address |
2161 PETTY CREEK RD |
| City | ALBERTON |
| State | MT |
| Zip Code | 59820-9401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134767304 | Josie Kolleen Hayes-johnson | Counselor | 314 Railroad Ave., Alberton, MT 59820 | 2019-12-18 |
| 1427513100 | Jessie Vaillancourt | Massage Therapist | 318 Perkins Creek Rd, Alberton, MT 59820 | 2019-02-06 |
| 1710382908 | Jen Fredette | Specialist | 512 Railroad Avenue, Alberton, MT 59820 | 2014-10-30 |
| 1083604367 | Beverly Jean Mcgowan | Nurse Practitioner | 31100 Yearling Run, Alberton, MT 59820-9326 | 2005-10-26 |
| 1811536089 | Sara Rausch | Registered Nurse | 13027 Lebaron Ln, Alberton, MT 59820-9496 | 2020-01-05 |
| 1457547911 | Joint School District No.2 | Local Education Agency (LEA) | 306 Railroad Ave, Alberton, MT 59820-9499 | 2007-09-19 |
| 1730438904 | Mineral Regional Health Center, Inc. | Clinic/Center | 306 Railroad Ave, Alberton, MT 59820-9499 | 2012-09-04 |
| 1356586648 | Judith Ann Kurien | Social Worker | 306 Railroad Ave, Alberton, MT 59820-9499 | 2008-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811536089 | Sara Rausch | Registered Nurse | 13027 Lebaron Ln, Alberton, MT 59820-9496 | 2020-01-05 |
| 1134767304 | Josie Kolleen Hayes-johnson | Counselor | 314 Railroad Ave., Alberton, MT 59820 | 2019-12-18 |
| 1427513100 | Jessie Vaillancourt | Massage Therapist | 318 Perkins Creek Rd, Alberton, MT 59820 | 2019-02-06 |
| 1710382908 | Jen Fredette | Specialist | 512 Railroad Avenue, Alberton, MT 59820 | 2014-10-30 |
| 1457547911 | Joint School District No.2 | Local Education Agency (LEA) | 306 Railroad Ave, Alberton, MT 59820-9499 | 2007-09-19 |
| 1083604367 | Beverly Jean Mcgowan | Nurse Practitioner | 31100 Yearling Run, Alberton, MT 59820-9326 | 2005-10-26 |
| 1730438904 | Mineral Regional Health Center, Inc. | Clinic/Center | 306 Railroad Ave, Alberton, MT 59820-9499 | 2012-09-04 |
| 1356586648 | Judith Ann Kurien | Social Worker | 306 Railroad Ave, Alberton, MT 59820-9499 | 2008-12-16 |
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811536105 | Rising Peak Academy | Substance Abuse Rehabilitation Facility | 2347 Middle Rd, Columbia Falls, MT 59912-9236 | 2020-01-03 |
| 1700319092 | 20 Peaks Ranch, Inc. | Substance Abuse Rehabilitation Facility | 391 Big Beaver Creek Rd, Trout Creek, MT 59874-9631 | 2017-04-04 |
| 1386066074 | Monarch School Inc. | Substance Abuse Rehabilitation Facility | 19 Aspen Ln, Heron, MT 59844-9506 | 2014-01-14 |
| 1801015581 | Florence Crittenton Home and Services Inc. | Substance Abuse Rehabilitation Facility | 901 North Harris, Helena, MT 59601 | 2007-04-24 |
| 1528305604 | Alternative Youth Care | Substance Abuse Rehabilitation Facility | 4880 Us Highway 93 S, Kalispell, MT 59901-7985 | 2013-01-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.