Organization
IDAHO CONSUMER DIRECT PERSONAL CARE, LLC
Active
Other names
Consumer Direct Personal Care, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BEN BLEDSOE (PRESIDENT/CEO)
(406) 532-2001
Entity
Organization
Contact information
Practice address
280 E CORPORATE DR STE 150, MERIDIAN, ID 83642-2952
(208) 898-0470
Mailing address
100 CONSUMER DIRECT WAY, MISSOULA, MT 59808-5037
(406) 532-1900
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8079334-00
—
ID
05
—
8079334-01
—
ID
Enumeration date
03/11/2008
Last updated
12/26/2017
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