Provider Demographics
NPI:1174781207
Name:CONSOLIDATED CARE INC
Entity type:Organization
Organization Name:CONSOLIDATED CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:REMINDER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:937-465-8065
Mailing Address - Street 1:PO BOX 817
Mailing Address - Street 2:1521 N DETROIT ST
Mailing Address - City:WEST LIBERTY
Mailing Address - State:OH
Mailing Address - Zip Code:43357-0817
Mailing Address - Country:US
Mailing Address - Phone:937-465-8065
Mailing Address - Fax:937-465-0442
Practice Address - Street 1:1521 N DETROIT ST
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:OH
Practice Address - Zip Code:43357-0817
Practice Address - Country:US
Practice Address - Phone:937-465-8065
Practice Address - Fax:937-465-0442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2485743Medicaid
OH2485743Medicaid