Provider Demographics
NPI:1477271823
Name:BALANCED LIVING, L.L.C
Entity Type:Organization
Organization Name:BALANCED LIVING, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NASRA
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:GIAM
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:763-203-9496
Mailing Address - Street 1:16019 ESTATE LN
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-2269
Mailing Address - Country:US
Mailing Address - Phone:763-203-9496
Mailing Address - Fax:
Practice Address - Street 1:16019 ESTATE LN
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-2269
Practice Address - Country:US
Practice Address - Phone:763-203-9496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care