Provider Demographics
NPI:1437695103
Name:BALANCED RECOVERY, INC
Entity type:Organization
Organization Name:BALANCED RECOVERY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPCC, LCADC
Authorized Official - Phone:859-687-0416
Mailing Address - Street 1:151 COCONUT GROVE DR
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2321
Mailing Address - Country:US
Mailing Address - Phone:859-687-0416
Mailing Address - Fax:
Practice Address - Street 1:1795 ALYSHEBA WAY
Practice Address - Street 2:SUITE 1001
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2280
Practice Address - Country:US
Practice Address - Phone:859-687-0416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility