Provider Demographics
NPI:1679015861
Name:LIFE BALANCE & BEAUTY
Entity Type:Organization
Organization Name:LIFE BALANCE & BEAUTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIGIT
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:813-857-3295
Mailing Address - Street 1:10013 WATER WORKS LANE
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578
Mailing Address - Country:US
Mailing Address - Phone:813-857-3295
Mailing Address - Fax:
Practice Address - Street 1:10013 WATER WORKS LANE
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578
Practice Address - Country:US
Practice Address - Phone:813-857-3295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-06
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11514101Y00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty