Provider Demographics
NPI:1629557509
Name:BALANCED MIND CENTERS LLC
Entity Type:Organization
Organization Name:BALANCED MIND CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:URI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEN-SHIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-323-1323
Mailing Address - Street 1:2780 S JONES BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5625
Mailing Address - Country:US
Mailing Address - Phone:702-323-1323
Mailing Address - Fax:
Practice Address - Street 1:2780 S JONES BLVD STE 115
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5625
Practice Address - Country:US
Practice Address - Phone:702-323-1323
Practice Address - Fax:702-405-6036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV201517355202084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty