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General NPI Number Information
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NPI Number | 1730618265
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Entity Type | Organization
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Legal Business Name | BALANCED LIFE HEALTH CARE SOLUTIONS LLC
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 555 OLD NORCROSS RD STE 250
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8703
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Country | US
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Telephone | 770-696-4541
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Fax | 770-271-9787
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Provider Business Mailing Address
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Address Line | 555 OLD NORCROSS RD STE 250
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8703
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Country | US
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Telephone | 770-696-4541
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Fax | 770-271-9787
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Authorized Official
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Title or Position | FNP/PROVIDER MANAGER
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Name | DR. TONITA WASHINGTON
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Credential | DNP, FNP-BC
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Telephone | 770-331-6475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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