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General NPI Number Information
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NPI Number | 1770271462
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Entity Type | Organization
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Legal Business Name | RIDGEMOOR CASE MANAGEMENT SERVICES INC.
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 201 INTERNATIONAL DR APT 642
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City | CAPE CANAVERAL
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State | FL
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Zip | 32920-3675
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Country | US
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Telephone | 616-437-0545
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Fax | 616-245-0107
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Provider Business Mailing Address
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Address Line | PO BOX 6525
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City | GRAND RAPIDS
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State | MI
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Zip | 49516-6525
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Country | US
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Telephone | 616-325-1212
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Fax | 616-245-0107
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Authorized Official
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Title or Position | OWNER/SUPERVISOR
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Name | MS. CINDY LOU STOWE
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Credential | RN
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Telephone | 616-325-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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