Provider Demographics
NPI:1467058057
Name:BALM OF CARE INCORPORATED
Entity Type:Organization
Organization Name:BALM OF CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EBENEZER
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINYELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-985-7283
Mailing Address - Street 1:19221 BEECHNUT ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-5208
Mailing Address - Country:US
Mailing Address - Phone:909-685-7283
Mailing Address - Fax:
Practice Address - Street 1:19221 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-5208
Practice Address - Country:US
Practice Address - Phone:909-685-7283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health