Healthcare Provider Details

I. General information

NPI: 1255436564
Provider Name (Legal Business Name): MOTIVATIONAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 PLEASANT ST
WATERVILLE ME
04901-5456
US

IV. Provider business mailing address

PO BOX 229
AUGUSTA ME
04332-0229
US

V. Phone/Fax

Practice location:
  • Phone: 207-626-3465
  • Fax: 207-626-3469
Mailing address:
  • Phone: 207-626-3465
  • Fax: 207-626-3469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number231968
License Number StateME

VIII. Authorized Official

Name: DR. RICHARD M WEISS
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 207-626-3465