Provider Demographics
NPI:1609206762
Name:CONSUMER DIRECTED SERVICES LLC
Entity Type:Organization
Organization Name:CONSUMER DIRECTED SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:314-524-9386
Mailing Address - Street 1:6154 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63134-2104
Mailing Address - Country:US
Mailing Address - Phone:314-524-9386
Mailing Address - Fax:
Practice Address - Street 1:6154 MADISON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63134-2104
Practice Address - Country:US
Practice Address - Phone:314-524-9386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCMS13-0015251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health