Provider Demographics
NPI:1619090628
Name:CONSUMER CARE LLC
Entity type:Organization
Organization Name:CONSUMER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CADC
Authorized Official - Phone:208-226-4637
Mailing Address - Street 1:1133 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-2717
Mailing Address - Country:US
Mailing Address - Phone:208-234-9361
Mailing Address - Fax:208-236-1855
Practice Address - Street 1:645 W CLARK ST
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-3141
Practice Address - Country:US
Practice Address - Phone:208-234-9361
Practice Address - Fax:208-909-2662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID8055295Medicaid
ID8055566Medicaid
ID8055528Medicaid