Provider Demographics
NPI:1184744799
Name:MAXIMUM PERSONAL ACHIEVEMENT SERVICES INC
Entity type:Organization
Organization Name:MAXIMUM PERSONAL ACHIEVEMENT SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORPORATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEZLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:419-692-2318
Mailing Address - Street 1:535 N SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-1551
Mailing Address - Country:US
Mailing Address - Phone:419-692-2318
Mailing Address - Fax:419-692-2372
Practice Address - Street 1:535 N SCOTT ST
Practice Address - Street 2:
Practice Address - City:DELPHOS
Practice Address - State:OH
Practice Address - Zip Code:45833-1551
Practice Address - Country:US
Practice Address - Phone:419-692-2318
Practice Address - Fax:419-692-2372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0200320251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2334156Medicaid
OH0200320OtherMBS CONTRACTOR NUMBER