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General NPI Number Information
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NPI Number | 1548853724
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Entity Type | Organization
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Legal Business Name | BALANCED LIFE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 02/18/2021
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | 506 MARGARET ST
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City | SOUTH POINT
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State | OH
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Zip | 45680-8402
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Country | US
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Telephone | 606-388-3120
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Fax | 888-384-2620
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Provider Business Mailing Address
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Address Line | 801 MCCULLOUGH ST
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City | ASHLAND
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State | KY
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Zip | 41102-4449
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Country | US
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Telephone | 606-585-4119
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTI J. REEVES
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Credential | LISW
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Telephone | 606-585-4119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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