Provider Demographics
NPI:1679113674
Name:BIG SKY ACADEMY
Entity type:Organization
Organization Name:BIG SKY ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC
Authorized Official - Phone:406-825-2600
Mailing Address - Street 1:12508 CRAMER CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MT
Mailing Address - Zip Code:59825
Mailing Address - Country:US
Mailing Address - Phone:406-825-2600
Mailing Address - Fax:406-825-3487
Practice Address - Street 1:12508 CRAMER CREEK ROAD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MT
Practice Address - Zip Code:59825
Practice Address - Country:US
Practice Address - Phone:406-825-2600
Practice Address - Fax:406-825-3487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children