Provider Demographics
NPI:1841755402
Name:THE MOTIVATIONAL EDGE
Entity Type:Organization
Organization Name:THE MOTIVATIONAL EDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WELSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-269-9831
Mailing Address - Street 1:2103 CORAL WAY FL 2
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2601
Mailing Address - Country:US
Mailing Address - Phone:786-269-9831
Mailing Address - Fax:
Practice Address - Street 1:1550 NW 36TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5560
Practice Address - Country:US
Practice Address - Phone:786-542-1609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health