Provider Demographics
NPI:1770271462
Name:RIDGEMOOR CASE MANAGEMENT SERVICES INC.
Entity type:Organization
Organization Name:RIDGEMOOR CASE MANAGEMENT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:STOWE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:616-325-1212
Mailing Address - Street 1:PO BOX 6525
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49516-6525
Mailing Address - Country:US
Mailing Address - Phone:616-325-1212
Mailing Address - Fax:616-245-0107
Practice Address - Street 1:201 INTERNATIONAL DR APT 642
Practice Address - Street 2:
Practice Address - City:CAPE CANAVERAL
Practice Address - State:FL
Practice Address - Zip Code:32920-3675
Practice Address - Country:US
Practice Address - Phone:616-437-0545
Practice Address - Fax:616-245-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty