| Cean Mental Wellness Services Llc | |
|
245 Andrea Dr Rockaway NJ 07866-3705 | |
| (973) 873-3083 | |
| (862) 520-1628 |
| Full Name | Cean Mental Wellness Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 245 Andrea Dr, Rockaway, New Jersey |
| Authorized Official Name and Position | Chioma Eunice Agbo (OWNER) |
| Authorized Official Contact | 9738733083 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cean Mental Wellness Services Llc 245 Andrea Dr Rockaway NJ 07866-3705 Ph: (973) 873-3083 | Cean Mental Wellness Services Llc 245 Andrea Dr Rockaway NJ 07866-3705 Ph: (973) 873-3083 |
| NPI Number | 1619595915 |
|---|---|
| Provider Enumeration Date | 07/13/2020 |
| Last Update Date | 10/25/2022 |
| Certification Date | 10/25/2022 |
| Medicare PECOS PAC ID | 4183041163 |
|---|---|
| Medicare Enrollment ID | O20200908000446 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619595915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| Provider Name | Chioma E Agbo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528535465 PECOS PAC ID: 6002153277 Enrollment ID: I20190125000575 |
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