MEDICARE: CONSUMER DIRECT FOR CALIFORNIA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1962667378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONSUMER DIRECT FOR CALIFORNIA, LLC

Provider Business Mailing Address
First Line	:	1903 S RUSSELL ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-6603
Country	:	US
Telephone Number	:	406-532-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1903 S RUSSELL ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-6603
Country	:	US
Telephone Number	:	406-532-1900
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	GREER WOODY
Credential	:
Telephone Number	:	406-532-1900

Provider Enumeration Date	:	07/24/2008
Last Update Date	:	07/24/2008

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