Provider Demographics
NPI:1750656807
Name:BALANCE MENTAL HEALTH
Entity Type:Organization
Organization Name:BALANCE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:WRIGHT
Authorized Official - Last Name:BRAGG
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:304-427-0005
Mailing Address - Street 1:11 N KANAWHA ST
Mailing Address - Street 2:PO BOX 2379
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2713
Mailing Address - Country:US
Mailing Address - Phone:304-472-0005
Mailing Address - Fax:888-606-1919
Practice Address - Street 1:11 N KANAWHA ST
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2713
Practice Address - Country:US
Practice Address - Phone:304-472-0005
Practice Address - Fax:888-606-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health