Provider Demographics
NPI:1619543014
Name:BALANCED HEALTH LLC
Entity Type:Organization
Organization Name:BALANCED HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER AND PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:864-243-8158
Mailing Address - Street 1:3302 NEW EASLEY HWY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-7137
Mailing Address - Country:US
Mailing Address - Phone:864-243-8158
Mailing Address - Fax:
Practice Address - Street 1:3302 NEW EASLEY HWY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-7137
Practice Address - Country:US
Practice Address - Phone:864-243-8158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty