Chane Reaction Llc | |
30800 Northwestern Hwy Ste 100 Farmington Hills MI 48334-5413 | |
(248) 497-6928 | |
Not Available |
Full Name | Chane Reaction Llc |
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Speciality | Social Worker |
Location | 30800 Northwestern Hwy Ste 100, Farmington Hills, Michigan |
Authorized Official Name and Position | Cathy Gallegos (MANAGER) |
Authorized Official Contact | 5174832461 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Chane Reaction Llc 30800 Northwestern Hwy Ste 100 Farmington Hills MI 48334-5413 Ph: (248) 497-6928 | Chane Reaction Llc 30800 Northwestern Hwy Ste 100 Farmington Hills MI 48334-5413 Ph: (248) 497-6928 |
NPI Number | 1467086686 |
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Provider Enumeration Date | 02/26/2020 |
Last Update Date | 01/28/2021 |
Certification Date | 01/28/2021 |
Medicare PECOS PAC ID | 9032523733 |
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Medicare Enrollment ID | O20210120001820 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467086686 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Gwendolyn E Chaney |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1841444866 PECOS PAC ID: 5496811606 Enrollment ID: I20090312000377 |
Provider Name | Brian Chaney |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1710511928 PECOS PAC ID: 3971917253 Enrollment ID: I20210129000723 |
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