Healthcare Provider Details

I. General information

NPI: 1487568838
Provider Name (Legal Business Name): SIMPLY SUPPORTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 S 2ND ST E
RIVERTON WY
82501-4324
US

IV. Provider business mailing address

202 S 2ND ST E
RIVERTON WY
82501-4324
US

V. Phone/Fax

Practice location:
  • Phone: 307-463-0607
  • Fax:
Mailing address:
  • Phone: 307-463-0607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. JULIE PETERSON
Title or Position: DIRECTOR OF OPERATIONS/OWNER
Credential:
Phone: 915-433-2613