Provider Demographics
NPI:1518628023
Name:BALANCE BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:BALANCE BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:W
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:404-736-1410
Mailing Address - Street 1:1010 HUNTCLIFF STE 1230
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-1898
Mailing Address - Country:US
Mailing Address - Phone:404-736-1410
Mailing Address - Fax:
Practice Address - Street 1:1010 HUNTCLIFF STE 1230
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-1898
Practice Address - Country:US
Practice Address - Phone:404-736-1410
Practice Address - Fax:901-457-4568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty