Provider Demographics
NPI:1467749663
Name:TOTAL BALNCE CENTER
Entity Type:Organization
Organization Name:TOTAL BALNCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROMWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-368-8949
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:5 AUSTIN DR UNIT 2
Mailing Address - City:MARLBOROUGH
Mailing Address - State:CT
Mailing Address - Zip Code:06447-0331
Mailing Address - Country:US
Mailing Address - Phone:860-368-8949
Mailing Address - Fax:
Practice Address - Street 1:5 AUSTIN DR
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:CT
Practice Address - Zip Code:06447-0331
Practice Address - Country:US
Practice Address - Phone:860-368-8949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001328251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health