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General NPI Number Information
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NPI Number | 1124371083
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Entity Type | Organization
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Legal Business Name | A BALANCED CHANGE, LLC
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 8138 COHN ST
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City | NEW ORLEANS
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State | LA
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Zip | 70118-2802
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Country | US
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Telephone | 504-610-7045
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Fax |
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Provider Business Mailing Address
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Address Line | 4725 TAFT PARK
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City | METAIRIE
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State | LA
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Zip | 70002-1438
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Country | US
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Telephone | 504-610-7045
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Fax |
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Authorized Official
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Title or Position | OWNER AND MANAGER
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Name | MICHAEL BROWN
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Credential |
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Telephone | 504-913-0928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | RN064592
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 4846
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License Number State | LA
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