Provider Demographics
NPI:1205529211
Name:KEY MOTIVATIONAL SERVICES PLLC
Entity type:Organization
Organization Name:KEY MOTIVATIONAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRICE
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCA, LCASA
Authorized Official - Phone:252-373-1224
Mailing Address - Street 1:2605 NASH ST NW STE B
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-1340
Mailing Address - Country:US
Mailing Address - Phone:252-265-3555
Mailing Address - Fax:
Practice Address - Street 1:2506 NASH ST N STE A
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-1393
Practice Address - Country:US
Practice Address - Phone:252-265-3555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health