Organization
ADOLESCENCE IN MOTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEHAN CRUMP-GIBSON (VICE PRESIDENT)
(313) 205-3295
Entity
Organization
Contact information
Practice address
237 N OLD WOODWARD AVE STE 5, BIRMINGHAM, MI 48009-5305
(248) 723-7152
Mailing address
237 N OLD WOODWARD AVE STE 5, BIRMINGHAM, MI 48009-5305
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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