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General NPI Number Information
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NPI Number | 1760237846
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Entity Type | Organization
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Legal Business Name | CONSUMER DIRECT CARE NETWORK SOUTH DAKOTA, LLC
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 05/04/2024
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Provider Practice Location Address
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Address Line | 100 CONSUMER DIRECT WAY
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City | MISSOULA
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State | MT
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Zip | 59808-5037
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Country | US
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Telephone | 406-532-2926
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Fax |
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Provider Business Mailing Address
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Address Line | 100 CONSUMER DIRECT WAY
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City | MISSOULA
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State | MT
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Zip | 59808-5037
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Country | US
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Telephone | 406-532-2926
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BEN BLEDSOE
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Credential |
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Telephone | 406-532-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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