Healthcare Provider Details

I. General information

NPI: 1760996433
Provider Name (Legal Business Name): BALANCE RECOVERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2017
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MAIN ST STE 103
NASHUA NH
03060-2720
US

IV. Provider business mailing address

60 MAIN ST STE 103
NASHUA NH
03060-2720
US

V. Phone/Fax

Practice location:
  • Phone: 603-563-0787
  • Fax: 603-632-3644
Mailing address:
  • Phone: 603-563-0787
  • Fax: 603-632-3644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YVONNE POINDEXTER
Title or Position: PRESIDENT
Credential:
Phone: 603-563-0787