Provider Demographics
NPI:1699153262
Name:CONSUMER DIRECT HOSPICE, LLC
Entity type:Organization
Organization Name:CONSUMER DIRECT HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
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:406-532-2001
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 1:3301 GREAT NORTHERN AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1574
Practice Address - Country:US
Practice Address - Phone:406-541-8700
Practice Address - Fax:406-541-8704
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONSUMER DIRECT HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health