Healthcare Provider Details

I. General information

NPI: 1447906250
Provider Name (Legal Business Name): TOTAL BALANCE HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8417 WASHINGTON PL NE STE A
ALBUQUERQUE NM
87113-1720
US

IV. Provider business mailing address

8417 WASHINGTON PL NE STE A
ALBUQUERQUE NM
87113-1720
US

V. Phone/Fax

Practice location:
  • Phone: 505-273-9453
  • Fax: 505-503-1619
Mailing address:
  • Phone: 505-273-9453
  • Fax: 505-503-1619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANDREA BENAVIDEZ
Title or Position: OWNER
Credential: FNP-C, PMHNP-BC
Phone: 505-273-9453