Provider Demographics
NPI:1487952362
Name:MOTIVATION & INSPIRATION FAMILY SERVICES
Entity type:Organization
Organization Name:MOTIVATION & INSPIRATION FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:RALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-566-3730
Mailing Address - Street 1:7008 E WT HARRIS BLVD STE 7
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-4298
Mailing Address - Country:US
Mailing Address - Phone:704-566-3730
Mailing Address - Fax:
Practice Address - Street 1:7008 E WT HARRIS BLVD STE 7
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-4298
Practice Address - Country:US
Practice Address - Phone:704-566-3730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health