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General NPI Number Information
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NPI Number | 1124389044
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Entity Type | Organization
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Legal Business Name | BALANCED MINDS LLC
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Dates
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Enumeration Date | 06/07/2012
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 8220 WHISTLER ROAD
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City | RICHMOND
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State | VA
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Zip | 23227-1257
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Country | US
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Telephone | 804-683-8114
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Fax | 804-321-1419
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Provider Business Mailing Address
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Address Line | 8220 WHISTLER RD
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City | RICHMOND
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State | VA
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Zip | 23227-1527
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Country | US
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Telephone | 804-683-8114
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Fax | 804-321-1419
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MARLON LANCASTER
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Credential |
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Telephone | 804-683-8114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | VA
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