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General NPI Number Information
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NPI Number | 1184497141
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Entity Type | Organization
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Legal Business Name | INNER BALANCE COUNSELING
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 451 W MELROSE ST APT 610
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City | CHICAGO
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State | IL
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Zip | 60657-3826
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Country | US
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Telephone | 773-318-7482
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Fax |
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Provider Business Mailing Address
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Address Line | 3023 N CLARK ST STE 183
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City | CHICAGO
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State | IL
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Zip | 60657-5200
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Country | US
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Telephone | 773-318-7482
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ARTHUR AVALOS JR.
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Credential |
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Telephone | 773-318-7482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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License Number State |
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