Provider Demographics
NPI:1255852638
Name:BALANCE RECOVERY LLC
Entity Type:Organization
Organization Name:BALANCE RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISSY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MSP
Authorized Official - Phone:208-287-3285
Mailing Address - Street 1:2995 N COLE RD STE 255
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-5976
Mailing Address - Country:US
Mailing Address - Phone:208-287-3285
Mailing Address - Fax:208-995-2896
Practice Address - Street 1:2995 N COLE RD STE 255
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5976
Practice Address - Country:US
Practice Address - Phone:208-287-3285
Practice Address - Fax:208-995-2896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health