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General NPI Number Information
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NPI Number | 1104316264
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Entity Type | Organization
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Legal Business Name | INTO BALANCE, LLC
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 7257 ANDY DR
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City | LINCOLN
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State | NE
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Zip | 68516-1021
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Country | US
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Telephone | 402-853-2396
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 NORMAL BLVD STE D
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City | LINCOLN
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State | NE
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Zip | 68506-6300
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Country | US
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Telephone | 402-853-2396
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | RICHARD ANDREW BUSS
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Credential | MS ED, LIMHP
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Telephone | 402-853-2396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1123
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License Number State | NE
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