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General NPI Number Information
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NPI Number | 1770327454
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Entity Type | Organization
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Legal Business Name | LIFE BALANCE SUPPORT SERVICES INC
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Dates
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Enumeration Date | 06/19/2024
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 2131 HOLLYWOOD BLVD STE 401
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6775
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Country | US
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Telephone | 786-208-9094
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Fax | 305-422-9029
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Provider Business Mailing Address
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Address Line | 2131 HOLLYWOOD BLVD STE 401
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6775
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Country | US
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Telephone | 954-366-9888
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Fax | 305-422-9029
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE A MONTES SANTANA
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Credential | LMHC
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Telephone | 954-366-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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