=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730864125
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BALANCED SOLUTIONS HEALTHCARE SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2023
-----------------------------------------------------
Last Update Date | 08/16/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 824 E WHEEL RD
-----------------------------------------------------
City | BEL AIR
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21015-6319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-412-4001
-----------------------------------------------------
Fax | 410-836-6789
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 824 E WHEEL RD
-----------------------------------------------------
City | BEL AIR
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21015-6319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-412-4001
-----------------------------------------------------
Fax | 410-836-6789
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING OWNER
-----------------------------------------------------
Name | BEVERLEY D ALSTON
-----------------------------------------------------
Credential | MPA
-----------------------------------------------------
Telephone | 410-412-4001
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------