Provider Demographics
NPI:1992875413
Name:MOBIUS, INC.
Entity type:Organization
Organization Name:MOBIUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:207-563-3511
Mailing Address - Street 1:319 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543-4654
Mailing Address - Country:US
Mailing Address - Phone:207-563-3511
Mailing Address - Fax:207-563-3561
Practice Address - Street 1:319 MAIN ST
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4654
Practice Address - Country:US
Practice Address - Phone:207-563-3511
Practice Address - Fax:207-563-3561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME109360000Medicaid
ME109360101Medicaid
ME109360200Medicaid
ME109360204Medicaid
ME109360206Medicaid
ME109360203Medicaid
ME109360001Medicaid
ME109360100Medicaid
ME109360205Medicaid
ME109360201Medicaid