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General NPI Number Information
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NPI Number | 1568355485
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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 | 05/30/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 19041 E 12 MILE RD # 103
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City | ROSEVILLE
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State | MI
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Zip | 48066-2609
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Country | US
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Telephone | 586-580-9486
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Fax | 586-200-0149
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Provider Business Mailing Address
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Address Line | 19041 E 12 MILE RD # 103
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City | ROSEVILLE
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State | MI
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Zip | 48066-2609
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Country | US
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Telephone | 586-580-9486
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Fax | 586-200-0149
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANKUR PATEL
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Credential |
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Telephone | 248-632-8182
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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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