Healthcare Provider Details

I. General information

NPI: 1154456366
Provider Name (Legal Business Name): CONSUMER DIRECT PERSONAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CONSUMER DIRECT WAY
MISSOULA MT
59808-5037
US

IV. Provider business mailing address

100 CONSUMER DIRECT WAY
MISSOULA MT
59808-5037
US

V. Phone/Fax

Practice location:
  • Phone: 406-532-1900
  • Fax: 406-532-8573
Mailing address:
  • Phone: 406-532-1900
  • Fax: 406-532-8573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: HOLLY STEPHENS
Title or Position: LEGAL MANAGER
Credential:
Phone: 406-532-1929