CB Supports of Michigan LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CB SUPPORTS OF MICHIGAN LLC

Practice address

24730 Harding St
Oak Park, MI 48237-1549

Phone

(718) 633-4411

NPI assigned

Jun 2, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Israel Benedek

Title

Ceo

Phone

(718) 336-6073

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1295359644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6214 24TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112043319",
            "telephone_number": "718-336-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24730 HARDING ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371549",
            "telephone_number": "718-633-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6214 24th Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112043319",
            "country_code": "US",
            "telephone_number": "718-336-6073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CB SUPPORTS OF MICHIGAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "BENEDEK",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-336-6073"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnnie Moneet Carter, RN
• Pearl Carter
• Blake A. Carthan
• Sophia Casanova, OTR/L
• Makeba Cawthon
• CDM Consulting LLC
• Mary Ann Ceasar, LMSW, ACSW
• Center for Reconstructive Surgery of the Foot Ankle & Leg, PLLC
• Centre HRW Inc
• Mitun Chablani

• Community/Behavioral Health Agency in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.