Provider Demographics
NPI:1477105914
Name:ABALANCE MARRIAGE AND FAMILY INC.
Entity Type:Organization
Organization Name:ABALANCE MARRIAGE AND FAMILY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAMKE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:209-262-4387
Mailing Address - Street 1:2930 GEER RD # 179
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-1142
Mailing Address - Country:US
Mailing Address - Phone:209-262-4387
Mailing Address - Fax:
Practice Address - Street 1:2101 GEER RD STE 102A
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2455
Practice Address - Country:US
Practice Address - Phone:209-262-4387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health