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NPI Code Detail

MEDICARE: THE BALANCING PLACE LLC

MEDICARE: THE BALANCING PLACE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1143374940OTHEROKNPI

General Provider Information

NPI Number : 1053060061
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE BALANCING PLACE LLC
Provider Business Mailing Address
First Line : 13355 NOEL RD STE 1100
Second Line :
City : DALLAS
State : TX
Zip : 75240-6694
Country : US
Telephone Number : 214-307-2183
Fax Number :
Provider Business Practice Location Address
First Line : 13355 NOEL RD STE 1100
Second Line :
City : DALLAS
State : TX
Zip : 75240-6694
Country : US
Telephone Number : 214-307-2183
Fax Number :
Authorized Official
Title or Position : OWNER
Name : REGINA M BUCHANAN
Credential : LPC-S
Telephone Number : 214-394-7823
Provider Enumeration Date : 03/18/2022
Last Update Date : 03/18/2022

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Directions to “THE BALANCING PLACE LLC ” Practice Location

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