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General NPI Number Information
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NPI Number | 1255566253
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Entity Type | Organization
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Legal Business Name | BALANCED HEALTH, LLC
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 300 HEBRON AVE SUITE 113
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City | GLASTONBURY
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State | CT
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Zip | 06033-2176
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Country | US
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Telephone | 860-930-0315
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Fax | 860-657-8556
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Provider Business Mailing Address
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Address Line | 531 NEIPSIC RD
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City | GLASTONBURY
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State | CT
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Zip | 06033-2452
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Country | US
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Telephone | 860-930-0315
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Fax | 860-657-8556
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Authorized Official
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Title or Position | OWNER
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Name | MS. RACHEL ANNETTE DONOVAN
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Credential | CNM
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Telephone | 860-930-0315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 0000139
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License Number State | CT
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