Provider Demographics
NPI:1376792127
Name:CONSUMERS CARE CORPORATION
Entity Type:Organization
Organization Name:CONSUMERS CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:MATTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-243-5484
Mailing Address - Street 1:4390 THURGOOD ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-3283
Mailing Address - Country:US
Mailing Address - Phone:404-243-5484
Mailing Address - Fax:404-243-5733
Practice Address - Street 1:4390 THURGOOD ESTATES DR
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-3283
Practice Address - Country:US
Practice Address - Phone:404-243-5484
Practice Address - Fax:404-243-5733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA089382234Medicaid