Provider Demographics
NPI:1366859316
Name:THE BALANCED LIVING CENTER, LLC
Entity Type:Organization
Organization Name:THE BALANCED LIVING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LPCC
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:440-941-0425
Mailing Address - Street 1:16600 W SPRAGUE RD STE 90
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-6318
Mailing Address - Country:US
Mailing Address - Phone:440-941-0425
Mailing Address - Fax:440-334-1000
Practice Address - Street 1:16600 W SPRAGUE RD STE 90
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-6318
Practice Address - Country:US
Practice Address - Phone:440-941-0425
Practice Address - Fax:440-334-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1400010101YP2500X
OHE.0008183101YP2500X
OHE.1000456101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty