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NPI 1174333074

NPI 1174333074 : INNER BALANCE MENTAL HEALTH LLC : DEER RIVER, MN

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General NPI Number Information
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    NPI Number           |    1174333074
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    Entity Type          |    Organization 
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    Legal Business Name  |    INNER BALANCE MENTAL HEALTH LLC 
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Dates
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    Enumeration Date     |    01/13/2025
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    Last Update Date     |    01/13/2025
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Provider Practice Location Address
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    Address Line         |    39513 KRANTZ DR 
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    City                 |    DEER RIVER
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    State                |    MN
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    Zip                  |    56636-4088
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    Country              |    US
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    Telephone            |    507-340-7649
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    39513 KRANTZ DR 
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    City                 |    DEER RIVER
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    State                |    MN
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    Zip                  |    56636-4088
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    Country              |    US
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    Telephone            |    507-340-7647
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER/PROVIDER
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    Name                 |     JOHN RICHARD FRANZEN 
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    Credential           |    PMHNP-BC
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    Telephone            |    507-340-7649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    103TC1900X
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    Taxonomy Name        |    Counseling Psychologist
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    License Number       |    
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    License Number State |    
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