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General NPI Number Information
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NPI Number | 1356135966
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Entity Type | Organization
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Legal Business Name | BALANCED MIND MENTAL HEALTH
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 300 PROSPECT AVE
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City | HOT SPRINGS
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State | AR
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Zip | 71901-4003
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Country | US
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Telephone | 501-223-9948
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20324
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City | HOT SPRINGS
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State | AR
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Zip | 71903-0324
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Country | US
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Telephone | 501-223-9948
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | JILL CULLEN
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Credential |
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Telephone | 501-223-9948
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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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