Provider Demographics
NPI:1225284961
Name:BALANCE, INC.
Entity Type:Organization
Organization Name:BALANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:R
Authorized Official - Last Name:MODAHL
Authorized Official - Suffix:
Authorized Official - Credentials:CISW
Authorized Official - Phone:262-268-6811
Mailing Address - Street 1:134 S FOSTER DR
Mailing Address - Street 2:
Mailing Address - City:SAUKVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53080-2005
Mailing Address - Country:US
Mailing Address - Phone:262-268-6811
Mailing Address - Fax:
Practice Address - Street 1:134 S FOSTER DR
Practice Address - Street 2:
Practice Address - City:SAUKVILLE
Practice Address - State:WI
Practice Address - Zip Code:53080-2005
Practice Address - Country:US
Practice Address - Phone:262-268-6811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services