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General NPI Number Information
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NPI Number | 1699168880
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Entity Type | Organization
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Legal Business Name | BALANCE HEALTH WELLNESS MHHA
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 6645 THILLE ST #195
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City | VENTURA
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State | CA
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Zip | 93003-7501
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Country | US
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Telephone | 805-651-0975
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Fax | 805-364-5944
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Provider Business Mailing Address
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Address Line | 6645 THILLE ST #195
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City | VENTURA
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State | CA
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Zip | 93003-7501
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Country | US
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Telephone | 805-651-0975
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Fax | 805-364-5944
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Authorized Official
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Title or Position | OWNER
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Name | MS. DAWN KATHLEEN GEHRI
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Credential | LVN, B.S.
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Telephone | 805-651-0975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | VN235627
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License Number State | CA
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