Provider Demographics
NPI:1093170714
Name:BALANCED MIND CENTERS LLC
Entity Type:Organization
Organization Name:BALANCED MIND CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AVI
Authorized Official - Middle Name:
Authorized Official - Last Name:OHAYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-400-0893
Mailing Address - Street 1:2780 S JONES BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5628
Mailing Address - Country:US
Mailing Address - Phone:702-323-1323
Mailing Address - Fax:
Practice Address - Street 1:2780 S JONES BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5628
Practice Address - Country:US
Practice Address - Phone:702-323-1323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health