Provider Demographics
NPI:1942058110
Name:WILDFLOWER CASE MANAGEMENT
Entity type:Organization
Organization Name:WILDFLOWER CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDGWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-394-1364
Mailing Address - Street 1:PO BOX 50142
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82605-0142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:580 GRANITE PEAK DR APT 208
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4529
Practice Address - Country:US
Practice Address - Phone:307-394-1364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management