Provider Demographics
NPI:1619334323
Name:CONSUMER DIRECT DISTRICT OF COLUMBIA
Entity Type:Organization
Organization Name:CONSUMER DIRECT DISTRICT OF COLUMBIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEDSOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-532-1900
Mailing Address - Street 1:125 BANK ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4412
Mailing Address - Country:US
Mailing Address - Phone:406-532-1929
Mailing Address - Fax:
Practice Address - Street 1:125 BANK ST STE 200
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4412
Practice Address - Country:US
Practice Address - Phone:406-532-1929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONSUMER DIRECT HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-26
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health