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General NPI Number Information
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NPI Number | 1891712675
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Entity Type | Organization
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Legal Business Name | ADULT ADOLESCENT CHILD PSYCHIATRIC SERVICESLLC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 7557 SECOR RD
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City | LAMBERTVILLE
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State | MI
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Zip | 48144-9624
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Country | US
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Telephone | 734-856-5056
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Fax | 734-856-7092
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Provider Business Mailing Address
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Address Line | 7557 SECOR RD
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City | LAMBERTVILLE
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State | MI
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Zip | 48144-9624
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Country | US
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Telephone | 734-856-5056
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Fax | 734-856-7092
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MANJU BAJPAI
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Credential | MD
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Telephone | 734-856-5056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 4301073215
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License Number State | MI
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