Provider Demographics
NPI:1609201524
Name:BALANCED HOME THERAPY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:BALANCED HOME THERAPY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEPLIN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:231-883-9822
Mailing Address - Street 1:4750 RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:KEWADIN
Mailing Address - State:MI
Mailing Address - Zip Code:49648-9338
Mailing Address - Country:US
Mailing Address - Phone:231-883-9822
Mailing Address - Fax:231-264-0268
Practice Address - Street 1:4750 RIDGE LN
Practice Address - Street 2:
Practice Address - City:KEWADIN
Practice Address - State:MI
Practice Address - Zip Code:49648-9338
Practice Address - Country:US
Practice Address - Phone:231-883-9822
Practice Address - Fax:231-264-0268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201006276225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty