Provider Demographics
NPI:1619457215
Name:THE BALANCED BEING LLC
Entity Type:Organization
Organization Name:THE BALANCED BEING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MT, C-IAYT, CIYT
Authorized Official - Phone:720-219-5622
Mailing Address - Street 1:1776 S JACKSON ST STE 830
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3807
Mailing Address - Country:US
Mailing Address - Phone:720-219-5622
Mailing Address - Fax:
Practice Address - Street 1:1776 S JACKSON ST STE 830
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3807
Practice Address - Country:US
Practice Address - Phone:720-219-5622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT-8091225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty