| Cb Well Llc | |
|
7 W Square Lake Rd Ste 111 Bloomfield Hills MI 48302-0462 | |
| (248) 452-5640 | |
| (248) 452-5681 |
| Full Name | Cb Well Llc |
|---|---|
| Speciality | Social Worker |
| Location | 7 W Square Lake Rd Ste 111, Bloomfield Hills, Michigan |
| Authorized Official Name and Position | Jeanne Ann Graves (ADMIN) |
| Authorized Official Contact | 2487099640 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cb Well Llc 2681 Dorchester Rd Birmingham MI 48009-5990 Ph: (517) 215-4900 | Cb Well Llc 7 W Square Lake Rd Ste 111 Bloomfield Hills MI 48302-0462 Ph: (248) 452-5640 |
| NPI Number | 1104672369 |
|---|---|
| Provider Enumeration Date | 04/29/2024 |
| Last Update Date | 08/25/2024 |
| Certification Date | 08/25/2024 |
| Medicare PECOS PAC ID | 1759823479 |
|---|---|
| Medicare Enrollment ID | O20240610003531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104672369 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Chad Brynly Cubberly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447809843 PECOS PAC ID: 8729428495 Enrollment ID: I20240429000405 |
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