=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619818572
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BALANCED VISION, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2026
-----------------------------------------------------
Last Update Date | 04/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1202 L ST
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68818-2016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-631-8847
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601 TERRIE RD
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68818-1132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-631-8847
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OCCUPATIONAL THERAPIST
-----------------------------------------------------
Name | KIMBERLY EBERLY
-----------------------------------------------------
Credential | OT
-----------------------------------------------------
Telephone | 402-631-8847
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------