Provider Demographics
NPI:1851511760
Name:CBC SERVICES LLC
Entity type:Organization
Organization Name:CBC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRINCIPLE PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CELESTINE
Authorized Official - Middle Name:ANNETT
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-485-8527
Mailing Address - Street 1:124 PEARL ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-2663
Mailing Address - Country:US
Mailing Address - Phone:734-485-8527
Mailing Address - Fax:734-629-0563
Practice Address - Street 1:124 PEARL ST
Practice Address - Street 2:SUITE 308
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-2663
Practice Address - Country:US
Practice Address - Phone:734-485-8527
Practice Address - Fax:734-629-0563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010640391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N91690Medicare ID - Type Unspecified
MI0N91690Medicare PIN