Healthcare Provider Details

I. General information

NPI: 1275453516
Provider Name (Legal Business Name): CONSUMER CARE SERVICES, LLC DBA SUPPORTING INDEPENDENCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 VESTER AVE STE C
SPRINGFIELD OH
45503-7300
US

IV. Provider business mailing address

1130 VESTER AVE STE C
SPRINGFIELD OH
45503-7300
US

V. Phone/Fax

Practice location:
  • Phone: 937-398-1635
  • Fax: 937-398-8984
Mailing address:
  • Phone: 937-398-1635
  • Fax: 937-398-8984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TRICIA L VENABLE
Title or Position: OWNER/DIRECTOR OF OPERATIONS
Credential: LSW, ATP
Phone: 937-398-1635