Provider Demographics
NPI:1427346170
Name:C.W. ENTERPRISE LLC
Entity type:Organization
Organization Name:C.W. ENTERPRISE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOBBYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-273-7095
Mailing Address - Street 1:32743 23 MILE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2082
Mailing Address - Country:US
Mailing Address - Phone:586-273-7095
Mailing Address - Fax:586-273-7196
Practice Address - Street 1:32743 23 MILE RD STE 130
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-2082
Practice Address - Country:US
Practice Address - Phone:586-273-7095
Practice Address - Fax:586-273-7196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI10591OtherBLUE CROSS