=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275453516
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CONSUMER CARE SERVICES, LLC DBA SUPPORTING INDEPENDENCE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2026
-----------------------------------------------------
Last Update Date | 07/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1130 VESTER AVE STE C
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45503-7300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-398-1635
-----------------------------------------------------
Fax | 937-398-8984
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1130 VESTER AVE STE C
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45503-7300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-398-1635
-----------------------------------------------------
Fax | 937-398-8984
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DIRECTOR OF OPERATIONS
-----------------------------------------------------
Name | TRICIA L VENABLE
-----------------------------------------------------
Credential | LSW, ATP
-----------------------------------------------------
Telephone | 937-398-1635
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320900000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------