| Organization Name: | RED TOP MEADOWS |
| NPI Number: | 1073826384 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRUCE BURKLAND (DIRECTOR) |
| Mailing Address: | 7905 S. Fall Creek Rd. Wilson |
| State: | WY US |
| Postal Code: | 83014 |
| Phone Number: | 3077339098 |
| Fax Number: | 3077337672 |
| NPI Enumeration Date: | 07/16/2010 |
| NPI Last Update Date: | 07/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | CMHW-057 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |