| Repairer Of The Breach Counseling And Consultant Services, Llc | |
|
319 Chandler St Detroit MI 48202-2857 | |
| (313) 451-4239 | |
| Not Available |
| Full Name | Repairer Of The Breach Counseling And Consultant Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 319 Chandler St, Detroit, Michigan |
| Authorized Official Name and Position | Yvonne Brooks (LEAD CLINICIAN) |
| Authorized Official Contact | 3134514239 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Repairer Of The Breach Counseling And Consultant Services, Llc 319 Chandler St Detroit MI 48202-2857 Ph: (313) 451-4239 | Repairer Of The Breach Counseling And Consultant Services, Llc 319 Chandler St Detroit MI 48202-2857 Ph: (313) 451-4239 |
| NPI Number | 1922571041 |
|---|---|
| Provider Enumeration Date | 01/11/2019 |
| Last Update Date | 01/12/2023 |
| Certification Date | 01/12/2023 |
| Medicare PECOS PAC ID | 3678991239 |
|---|---|
| Medicare Enrollment ID | O20200914001476 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922571041 | NPI | - | NPPES |
| 1184962763 | Other | NPI |
| Provider Name | Yvonne Rochelle Mcclean |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184962763 PECOS PAC ID: 2860813706 Enrollment ID: I20200914001610 |
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