Provider Demographics
NPI:1497802128
Name:BALANCE AUTISM
Entity Type:Organization
Organization Name:BALANCE AUTISM
Other - Org Name:THE HOMESTEAD AUTISM SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUANN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-957-3342
Mailing Address - Street 1:8272 NE UNIVERSITY AVENUE
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:IA
Mailing Address - Zip Code:50327-8030
Mailing Address - Country:US
Mailing Address - Phone:515-967-4369
Mailing Address - Fax:515-957-3380
Practice Address - Street 1:1625 ADVENTURELAND DR STE B
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-2237
Practice Address - Country:US
Practice Address - Phone:515-967-4369
Practice Address - Fax:515-957-3380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251C00000X, 315P00000X
IA770938315P00000X
IA1MR844315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0881276Medicaid
IA0881763Medicaid
IA0129635Medicaid