Provider Demographics
NPI:1124371083
Name:A BALANCED CHANGE, LLC
Entity Type:Organization
Organization Name:A BALANCED CHANGE, LLC
Other - Org Name:WOMEN'S HOPE NOLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-913-0928
Mailing Address - Street 1:4725 TAFT PARK
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1438
Mailing Address - Country:US
Mailing Address - Phone:504-610-7045
Mailing Address - Fax:
Practice Address - Street 1:8138 COHN ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-2802
Practice Address - Country:US
Practice Address - Phone:504-610-7045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN064592251J00000X
LA4846261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251J00000XAgenciesNursing Care