Provider Demographics
NPI:1851418834
Name:CIRCLE R CASE MANAGEMENT
Entity Type:Organization
Organization Name:CIRCLE R CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:RIPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-586-1800
Mailing Address - Street 1:94 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-8104
Mailing Address - Country:US
Mailing Address - Phone:307-586-1800
Mailing Address - Fax:307-587-9422
Practice Address - Street 1:94 BEVERLY DR
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-8104
Practice Address - Country:US
Practice Address - Phone:307-586-1800
Practice Address - Fax:307-587-9422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY122726200Medicaid