Provider Demographics
NPI:1396519765
Name:MOMENTUM THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:MOMENTUM THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARNI
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALEKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-733-5797
Mailing Address - Street 1:23650 WOODWARD AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:PLEASANT RIDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48069-1102
Mailing Address - Country:US
Mailing Address - Phone:248-733-5797
Mailing Address - Fax:
Practice Address - Street 1:23650 WOODWARD AVE STE 201
Practice Address - Street 2:
Practice Address - City:PLEASANT RIDGE
Practice Address - State:MI
Practice Address - Zip Code:48069-1102
Practice Address - Country:US
Practice Address - Phone:248-733-5797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty